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Targeted Healthcare Necessary for Pregnant Women, New Mothers With Depression
November 20, 2019

Prescription of antidepressants may be a useful marker to target additional support and additional care before and during pregnancy and lactation, according to a study published in PLOS ONE.

The study gives key insights into the link between antidepressants and preterm birth or low birthweight and also shows, for the first time, which babies were being breastfed at 6 to 8 weeks.
For the study, Sue Jordan, PhD, Swansea University, Swansea, United Kingdom, and colleagues used data curated by the SAIL Databank to examine data from more than 100,000 babies born between 2000 and 2010. This included 2,043 babies (1.9%) whose mothers were prescribed antidepressants throughout their pregnancy and 4,252 whose prescriptions stopped in the first trimester.

The researchers found that exclusive formula feeding at 6 to 8 weeks was associated with prescriptions in the second or third trimesters for any antidepressants (adjusted odds ratio [aOR] = 0.81; 95% confidence interval [CI], 0.67-0.98), selective serotonin reuptake inhibitors (SSRIs) (aOR = 0.77; 95% CI, 0.62-0.95), particularly higher doses (aOR = 0.45; 95% CI, 0.23-0.86), discontinuation of antidepressants or SSRIs after the first trimester (aOR = 0.70; 95% CI, 0.57-0.83 and aOR = 0.66; 95% CI, 0.51-0.87), diagnosis of depression (aOR = 0.76; 95% CI, 0.70-0.82), particularly if medicated (aOR = 0.70; 95% CI, 0.58-0.85), rather than unmedicated (aOR = 0.87; 95% CI, 0.82-0.92).

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“Our study makes for sobering reading,” said Dr. Jordan. “The data show which women are vulnerable to reduced breastfeeding rates, preterm delivery, and giving birth to small babies. The data should be considered alongside our previous reports of increased risks of congenital anomalies following antidepressant prescriptions in early pregnancy.”

“Women prescribed antidepressants could and should be identified from primary care prescription records and targeted for additional support before conception,” she concluded. “Our analysis makes a very strong case for closer monitoring for women prescribed antidepressants, including scans in the third trimester to check on the baby’s growth and development.”

Reference: http://dx.doi.org/10.1371/journal.pone.0225133

SOURCE: Swansea University