The impact of major depressive disorder and antidepressant medication before and during pregnancy on obstetric and neonatal outcomes: A nationwide population-based study

Wolgast, Emelie; Lilliecreutz, Caroline; Sydsjö, Gunilla; Bladh, Marie; Josefsson, Ann

doi:10.1016/j.ejogrb.2020.11.062

Cited by 5 publications

(3 citation statements)

References 29 publications

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“…However, only more recent studies have compared outcomes in offspring born to continuers versus discontinuers [ 61 ]. Antidepressant continuation in pregnancy was found to increase the risk of low birth weight, premature birth, or affective disorder diagnosis later in childhood [ 62 , 63 , 64 , 65 ]. Yet, the role of confounding by maternal disease severity remains an important concern in this research.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Peripartum Depression with Antidepressants and Other Psychotropic Medications: A Synthesis of Clinical Practice Guidelines in Europe

Kittel‐Schneider

Felice

Buhagiar

et al. 2022

IJERPH

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This study examined (1) the availability and content of national CPGs for treatment of peripartum depression, including comorbid anxiety, with antidepressants and other psychotropics across Europe and (2) antidepressant and other psychotropic utilization data as an indicator of prescribers’ compliance to the guidelines. We conducted a search using Medline and the Guidelines International Network database, combined with direct e-mail contact with national Riseup-PPD COST ACTION members and researchers within psychiatry. Of the 48 European countries examined, we screened 41 records and included 14 of them for full-text evaluation. After exclusion of ineligible and duplicate records, we included 12 CPGs. Multiple CPGs recommend antidepressant initiation or continuation based on maternal disease severity, non-response to first-line non-pharmacological interventions, and after risk-benefit assessment. Advice on treatment of comorbid anxiety is largely missing or unspecific. Antidepressant dispensing data suggest general prescribers’ compliance with the preferred substances of the CPG, although country-specific differences were noted. To conclude, there is an urgent need for harmonized, up-to-date CPGs for pharmacological management of peripartum depression and comorbid anxiety in Europe. The recommendations need to be informed by the latest available evidence so that healthcare providers and women can make informed, evidence-based decisions about treatment choices.

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Section: Discussionmentioning

confidence: 99%

Treatment of Peripartum Depression with Antidepressants and Other Psychotropic Medications: A Synthesis of Clinical Practice Guidelines in Europe

Kittel‐Schneider

Felice

Buhagiar

et al. 2022

IJERPH

View full text Add to dashboard Cite

show abstract

“…Given that most patients with antipsychotic treatment have severe mental illness, the decision to continue medication is mainly driven by the risk of relapse during pregnancy or right after delivery. Psychiatric relapse impairs the life functioning of the pregnant woman and her family, and has been demonstrated to be harmful for her offspring as well 13,32–36 . This relapse risk should be weighed against all potential adverse effects of antipsychotic medication on the child.…”

Section: Discussionmentioning

confidence: 99%

“…Psychiatric relapse impairs the life functioning of the pregnant woman and her family, and has been demonstrated to be harmful for her offspring as well. 13 , 32 , 33 , 34 , 35 , 36 This relapse risk should be weighed against all potential adverse effects of antipsychotic medication on the child.…”

Section: Discussionmentioning

confidence: 99%

Neurodevelopment in school‐aged children after intrauterine exposure to antipsychotics

Schrijver

Robakis

Kamperman

et al. 2022

Acta Psychiatr Scand

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Objective: Antipsychotics are increasingly prescribed in pregnancy, yet little is known about potential long-term developmental effects on children. In this study, we investigated the effect of prenatal antipsychotic exposure on neurodevelopmental functioning in school-aged children.Methods: We performed a cross-sectional neurodevelopmental assessment of 91 children aged 6-14 years whose mothers had severe mental illness and were either exposed or unexposed to antipsychotic medication during pregnancy.Neurodevelopmental outcomes were assessed using validated neurodevelopmental assessment instruments to examine the child's IQ and global cognitive functioning, and the presence of any psychiatric disorders and/or learning problems in the child was assessed by parental report.Results: No statistically significant associations were found between antipsychotic exposure during pregnancy and either adverse neurodevelopmental outcomes (IQ, neuropsychological function), likelihood of psychiatric diagnosis, or learning problems based on parental report. Analyses were likely limited in power to detect subtler differences in neurodevelopmental functioning because of small sample size and heterogeneity of the sample. Conclusions: In this exploratory cohort study, intrauterine exposure to antipsychotics was not associated with any adverse effect on IQ or neurodevelopmental functioning in a cohort of school-aged children (6-14 years).

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Selective Serotonin Reuptake Inhibitors (SSRIs) in Pregnancy: An Updated Review on Risks to Mother, Fetus, and Child

Lebin

Novick

2022

Curr Psychiatry Rep

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The impact of major depressive disorder and antidepressant medication before and during pregnancy on obstetric and neonatal outcomes: A nationwide population-based study

Cited by 5 publications

References 29 publications

Treatment of Peripartum Depression with Antidepressants and Other Psychotropic Medications: A Synthesis of Clinical Practice Guidelines in Europe

Treatment of Peripartum Depression with Antidepressants and Other Psychotropic Medications: A Synthesis of Clinical Practice Guidelines in Europe

Neurodevelopment in school‐aged children after intrauterine exposure to antipsychotics

Selective Serotonin Reuptake Inhibitors (SSRIs) in Pregnancy: An Updated Review on Risks to Mother, Fetus, and Child

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