Timing of selective serotonin reuptake inhibitor use and risk for preterm birth and related adverse events: with a consideration of the COVID-19 pandemic period.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-12-01 Epub Date: 2024-02-11 DOI:10.1080/14767058.2024.2313364

Yeon Mi Hwang, Ryan T Roper, Samantha N Piekos, Daniel A Enquobahrie, Mary F Hebert, Alison G Paquette, Priyanka Baloni, Nathan D Price, Leroy Hood, Jennifer J Hadlock

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Abstract

Objective: There is uncertainty around the safety of SSRIs for treating depression during pregnancy. Nevertheless, the use of SSRIs has been gradually increasing, especially during the COVID-19 pandemic period. We aimed to (1) characterize maternal depression rate and use of SSRIs in a recent 10-year period, (2) address confounding by indication, as well as socioeconomic and environmental factors, and (3) evaluate associations of the timing of SSRI exposure in pregnancy with risk for preterm birth (PTB), low birthweight (LBW), and small for gestational age (SGA) infants among women with depression before pregnancy.

Methods: We conducted propensity score-adjusted regression to calculate odds ratios (ORs) of PTB, LBW, and SGA. We accounted for maternal/pregnancy characteristics, comorbidity, depression severity, time of delivery, social vulnerability, and rural residence.

Results: There were 50.3% and 40.3% increases in the prevalence rate of prenatal depression and prenatal SSRI prescription rate during the pandemic. We identified women with depression ≤180 days before pregnancy (n = 8406). Women with no SSRI order during pregnancy (n = 3760) constituted the unexposed group. The late SSRI exposure group consisted of women with an SSRI order after the first trimester (n = 3759). The early-only SSRI exposure group consisted of women with SSRI orders only in the first trimester (n = 887). The late SSRI exposure group had an increased risk of PTB of OR = 1.5 ([1.2,1.8]) and LBW of OR = 1.5 ([1.2,2.0]), relative to the unexposed group. Associations between late SSRI exposure and risk of PTB/LBW were similar among a subsample of patients who delivered during the pandemic.

Conclusions: These findings suggest an association between PTB/LBW and SSRI exposure is dependent on exposure timing during pregnancy. Small for gestational age is not associated with SSRI exposure.

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选择性 5-羟色胺再摄取抑制剂的使用时机与早产及相关不良事件的风险：对 COVID-19 大流行时期的考虑。

目的：SSRIs治疗妊娠期抑郁症的安全性尚不确定。尽管如此，SSRIs 的使用仍在逐渐增加，尤其是在 COVID-19 大流行期间。我们的目的是：(1) 描述最近 10 年间孕产妇抑郁症发病率和 SSRIs 使用情况；(2) 解决适应症以及社会经济和环境因素造成的混淆问题；(3) 评估妊娠期 SSRI 暴露时间与孕前抑郁症妇女早产（PTB）、低出生体重（LBW）和小胎龄（SGA）婴儿风险的相关性：我们进行了倾向得分调整回归，以计算早产儿、低出生体重儿和小于胎龄儿的几率比（ORs）。我们考虑了产妇/孕期特征、合并症、抑郁严重程度、分娩时间、社会脆弱性和农村居住地等因素：结果：大流行期间，产前抑郁症患病率和产前 SSRI 处方率分别增加了 50.3% 和 40.3%。我们确定了怀孕前 180 天内患有抑郁症的妇女（n = 8406）。孕期未服用过 SSRI 的女性（n = 3760）构成了未暴露组。晚期 SSRI 暴露组包括在妊娠头三个月后服用 SSRI 的妇女（n = 3759）。仅在早期接触过 SSRI 的组别包括仅在妊娠头三个月接触过 SSRI 的妇女（n = 887）。与未暴露组相比，晚期SSRI暴露组患PTB的风险增加了OR=1.5（[1.2,1.8]），患LBW的风险增加了OR=1.5（[1.2,2.0]）。在大流行期间分娩的子样本中，晚期SSRI暴露与PTB/LBW风险之间的关系相似：这些研究结果表明，PTB/LBW 与 SSRI 暴露之间的关系取决于孕期的暴露时间。胎龄小与暴露于 SSRI 无关。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.