Pmh30 Antidepressant Therapy During Pregnancy: An Insight on Its Potential Health Care Costs

Ramos, Edivan Rodrigo de Paula; Berard, Aurélie

doi:10.1016/s1098-3015(10)66931-8

Cited by 1 publication

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“…Details about the registry have been published previously. 13,14 In brief, the registry is built with the linkage of three administrative databases: the Régie de l'assurance maladie du Québec (RAMQ), the Med-Echo database and the Institut de la statistique du Québec database. The RAMQ database provides prospectively collected data on filled prescriptions, physician-based diagnoses (according to the International Classification of Diseases, ninth revision [ICD-9]), 15 visits to physicians and emergency departments, medical services dispensed, admissions to hospital, and characteristics of health care providers and patients in the province of Quebec.…”

Section: Study Settingmentioning

confidence: 99%

Use of antidepressants during pregnancy and the risk of spontaneous abortion

Nakhai-Pour¹,

Broy²,

Bérard³

2010

Canadian Medical Association Journal

141

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; Centre hospitalier universitaire Sainte-Justine (Nakhai-Pour, Broy, Bérard), University of Montreal, Montréal, Que.; École nationale de la statistique et de l'analyse de l'information (Broy), Rennes, France; and the Ministry of Health and Medical Education (Nakhai-Pour), Tehran, Iran CMAJ 2010. DOI:10.1503/cmaj.091208 Background:The risk of relapse of depression or the diagnosis of some other psychiatric disorders during pregnancy necessitates the use of antidepressants despite possible adverse effects. Whether such use increases the risk of spontaneous abortion is still being debated. We evaluated the risk of spontaneous abortion in relation to the use of antidepressants during pregnancy. Methods:Using a nested case-control study design, we obtained data from the Quebec Pregnancy Registry for 5124 women who had a clinically detected spontaneous abortion. For each case, we randomly selected 10 controls from the remaining women in the registry who were matched by the case's index date (date of spontaneous abortion) and gestational age at the time of spontaneous abortion. Use of antidepressants was defined by filled prescriptions and was compared with nonuse. We also studied the classes, types and doses of antidepressants.Results: A total of 284 (5.5%) of the women who had a spontaneous abortion had at least one prescription for an anti depressant filled during the pregnancy, as compared with 1401 (2.7%) of the matched controls (odds ratio [OR] 2.09, 95% confidence interval [CI] 1.83-2.38). After adjustment for potential confounders, we found that the use of antidepressants during pregnancy was associated with an increased risk of spontaneous abortion (OR 1.68, 95%CI 1.38-2.06). Stratified analyses showed that use of selective serotonin reuptake inhibitors alone (OR 1.61, 95% CI 1.28-2.04), serotonin-norepinephrine reuptake inhibitors alone (OR 2.11, 95% CI 1.34-3.30) and combined use of antidepressants from different classes (OR 3.51, were associated with an increased risk of spontaneous abortion. When we looked at antidepressant use by type versus no use, paroxetine use alone (OR 1.75, 95% CI 1.31-2.34) and venlafaxine use alone (OR 2.11, 95% CI 1.34-3.30) were associated with an increased risk of spontaneous abortion. Interpretation:The use of antidepressants, especially paroxetine, venlafaxine or the combined use of different classes of antidepressants, during pregnancy was associated with an increased risk of spontaneous abortion. Abstract

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Section: Study Settingmentioning

confidence: 99%