Bupropion in pregnancy and the prevalence of congenital malformations

Cole, J. Alexander; Modell, Jack G.; Haight, Barbara R.; Cosmatos, Irene; Stoler, Joan M.; Walker, Alexander M.

doi:10.1002/pds.1296

Cited by 127 publications

(106 citation statements)

References 27 publications

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“…One high risk of bias observational study reported no increase in risk of congenital malformations associated with the use of bupropion during pregnancy compared with other antidepressants as a group in women with depression during pregnancy. 153 Indirect evidence from a larger (N=7005), medium risk of bias study, also reported no statistically significant increase in risk with bupropion compared with other antidepressants reported an adjusted OR of 0.95 (95% CI, 0.62 to 1.45), 40 Depression status of women in either group was not known in this study.…”

Section: Class Compared With Class: Selective Serotonin Reuptake Inhimentioning

confidence: 64%

“…While there are a few other studies that report the risk of malformations after exposure during the conception period for individual or grouped SSRIs, SNRIs, and individual drugs, 40,49,79,152 none controlled for more than two of the key confounders, and suffered from inferior methods for ascertainment of exposure or outcomes.…”

Section: Key Question 2b In Babies Born To Women Who Become Pregnantmentioning

confidence: 99%

“…Twenty-five observational studies reported maternal health outcomes for active SSRI treatment (as a class or as an individual drug), 45,49,52,55,62,65,66,76,78,82,83,85,98,100,107,114,129,145,147,149,150,154,156,159 with only three 40,55,156 explicitly including women with depression during pregnancy in both the intervention and control groups (i.e. direct evidence).…”

Section: Maternal Outcomesmentioning

confidence: 99%

See 2 more Smart Citations

Treatment of Depression During Pregnancy and the Postpartum Period

2013

PsycEXTRA Dataset

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Section: Class Compared With Class: Selective Serotonin Reuptake Inhimentioning

confidence: 64%

Section: Key Question 2b In Babies Born To Women Who Become Pregnantmentioning

confidence: 99%

Section: Maternal Outcomesmentioning

confidence: 99%

See 1 more Smart Citation

Treatment of Depression During Pregnancy and the Postpartum Period

2013

PsycEXTRA Dataset

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“…birthcertificate data) in the USA has previously been demonstrated to underrepresent outcomes of highrisk pregnancies, potentially introducing selection bias [Bronstein et al 2009]. An additional limitation of using claims databases from healthcare plans such as Medicaid, which is a healthcare plan for low-income persons, is that cohort members are not representative of those with private health insurance, limiting the generalizability of study findings [Cole et al 2007b]. Similarly, claims-based databases from private health insurers suffer from the limitation that analyses are restricted to those who maintain coverage with the health insurer during the defined study period, which could change as a result of changes in income, employment, and/or residence.…”

Section: Data Linkagementioning

confidence: 99%

Methodological challenges in using routinely collected health data to investigate long-term effects of medication use during pregnancy

Grzeskowiak

Gilbert

Morrison

2012

Therapeutic Advances in Drug Safety

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Abstract:To date, the investigation of teratogenic effects of medications has largely focused on physical alterations present at birth (i.e. malformations) as opposed to functional alterations (i.e. neurodevelopment, metabolic function) that may not be apparent at birth but could influence an individual's health and risk of disease in later life. The use of routinely collected health data represents one approach to better identifying, quantifying, and understanding the long-term risks or benefits of medication use during pregnancy. As such, the objective of this review was to identify and explore opportunities and challenges associated with using routinely collected health data to examine long-term effects of medication use during pregnancy. Drawing on published research several key methodological issues associated with their use in investigating long-term outcomes are reviewed. While significant opportunities exist to make greater use of routinely collected health data, there are a number of key challenges. Identified challenges relate to aspects of study design and analysis, and include obtaining access to data, the ability to match records across datasets and over long periods of time, how medication exposures are ascertained and classified, issues around loss to follow-up how outcomes are ascertained and classified, and the careful interpretation of results in light of study and data limitations. Understanding key challenges associated with using routinely collected health data to investigate long-term effects of medication use during pregnancy is essential in supporting their appropriate use and interpretation, which will contribute to improving the quality of research undertaken and ensure the reliability of results obtained.

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“…25 Another study suggests that bupropion may be safe to use in pregnancy with no increased risk of teratogenic effects when used during the first trimester compared with other antidepressants or when used outside of the first trimester. 26 More research is necessary in order to make recommendations for the use of bupropion during pregnancy.…”

Section: Smoking Cessation Treatmentsmentioning

confidence: 99%

Smoking cessation in pregnancy

Bittoun

Femia

2010

Obstet Med

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Summary: Managing smoking cessation during pregnancy is vital to the wellbeing of the fetus and the mother. Women who continue to smoke during pregnancy expose the fetus to thousands of chemicals which have been shown to cause deleterious shortand long-term effects. Although a large majority of women cease smoking early in the pregnancy, many of them relapse following delivery. Following a review of current research, an overview of the safety and efficacy of smoking cessation treatments for pregnant women will be considered. Limited research has been performed in this field; however, it can be concluded that low-dose intermittent nicotine replacement therapy is a safe treatment modality for women who smoke during pregnancy. At present there has been no research on other current smoking cessation treatments; however, we will suggest techniques to improve cessation rates and strategies to reduce relapse.

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Bupropion in pregnancy and the prevalence of congenital malformations

Abstract: Results do not support a hypothesis of a teratogenic effect of first trimester bupropion exposure. The prevalence of malformations associated with bupropion exposure in the first trimester was not increased relative to the comparison groups.

Cited by 127 publications

References 27 publications

Treatment of Depression During Pregnancy and the Postpartum Period

Treatment of Depression During Pregnancy and the Postpartum Period

Methodological challenges in using routinely collected health data to investigate long-term effects of medication use during pregnancy

Smoking cessation in pregnancy

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