Risks associated with antidepressants in patients with hypertension during pregnancy: a retrospective cohort study

Abstract

Objective In a cohort of pregnant women using antihypertensive drugs, we compared exposure to antidepressants versus no exposure and the possible association with birth weight, APGAR scores, NICU admission, and maternal admission to an obstetrical intensive care unit (OHC). It was hypothesized that pregnant women with hypertensive disorders using antidepressants are at greater risk of complications. Setting A retrospective cohort study in a general teaching hospital in Zwolle, in the Middle-Northern part of The Netherlands. Participants We selected 77 pregnancies eligible for the exposed group and 293 eligible for the reference group. Of those, we excluded patients because of twin pregnancy, stillbirth, patients who discontinued antidepressants during pregnancy, and termination of the pregnancy not related to hypertension or mental health problems during pregnancy. Finally, 58 pregnancies in the exposed group and 273 pregnancies in the reference group met all inclusion and exclusion criteria. Outcome We compared the neonate’s birthweight between the exposed to antidepressants group and the reference group as the primary outcome. Secondary outcomes were the APGAR score at 1 and 5 minutes and obstetric high care (OHC) admission of the mother and neonatal intensive care unit (NICU) admission of the child. Results We found no differences in birth weight in neonates of mothers with hypertensive disorders and whether or not to use antidepressants. Besides a possible higher risk of admission to an OHC in women with hypertension-complicated pregnancies using antidepressants, we found no other maternal or neonatal risks in this population. Conclusions We found no additional maternal or neonatal risks of using antidepressants prescribed to women with hypertension disorders during pregnancy.