Pregnancy: antidepressants, anxiolytics in first 16 weeks tied to preeclampsia

  • Bernard N & al.
  • BMC Pregnancy Childbirth
  • 30 Apr 2019

  • International Clinical Digest
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Takeaway

  • Exposure to antidepressants and/or anxiolytics during the first 16 weeks of pregnancy tripled the risk for preeclampsia, but cessation of those medications before the 16th week reduced the risk.
  • Use of an SNRI or a tricyclic antidepressant increased preeclampsia risk by more than 6- and 7-fold, respectively.

Why this matters

  • Nearly 5% of participants were exposed to antidepressants and/or anxiolytics during pregnancy.

Study design

  • Study of 6878 pregnant women.
  • Funding: Canadian Institutes of Health Research.

Key results

  • 4.9% of women received antidepressant and/or anxiolytic medication (before week 16, 3.16%).
  • 2.94% of women developed gestational hypertension and 1.85% developed preeclampsia.
  • Women who received antidepressant and/or anxiolytic drugs within week 16 gestation showed higher risk for preeclampsia (aOR, 3.09; P=.001) vs those who did not.
    • SNRIs were tied to 6.46-fold risk (aOR, 6.46; P<.0001>
    • Risk was not statistically significant in tricyclic antidepressant users (P=.27).
  • Compared with women not exposed to the antidepressant/anxiolytic medication, depression, or anxiety, risk for preeclampsia was:
    • Significantly higher with continued antidepressant and/or anxiolytic drugs after 16 weeks (aOR, 3.41; P=.001).
    • Statistically similar in women who discontinued antidepressant and/or anxiolytic medications before 16 weeks (aOR, 1.60; 95% CI, 0.21-12.34, crossing the unity barrier).

Limitations

  • Small number of antidepressant and anxiolytic users.

Coauthored with Antara Ghosh, PhD

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