Ververs Tessa, Kaasenbrood Hans, Visser Gerard, Schobben Fred, de Jong-van den Berg Lolkje, Egberts Toine
Department of Clinical Pharmacy, Clinical Chemistry and Laboratory Medicine, University Medical Center (UMC) Utrecht, Utrecht, The Netherlands.
Eur J Clin Pharmacol. 2006 Oct;62(10):863-70. doi: 10.1007/s00228-006-0177-0. Epub 2006 Aug 8.
The aim of this study was to determine the extent and patterns of antidepressant use before, during and after pregnancy in a large population in The Netherlands.
Health care records and prescription data from one of the largest Dutch health insurance companies were analysed. The study cohort consisted of 29,005 women who had live births in the period between January 2000 and July 2003. Antidepressant drug use during a specified period was defined as there being a record of a prescription during that period.
During the first trimester of pregnancy 2% of all pregnant women of the study cohort were found to have taken antidepressants; in the second and third trimesters, this figure had dropped to 1.8% of all pregnancies. Antidepressant use before as well as during pregnancy was almost twofold higher in women over 35 years of age than in those under 35 years. Almost 60% of the women who used antidepressants before pregnancy stopped taking them in the first trimester, and a smaller number stopped thereafter. Of all women using antidepressants during pregnancy, one third started this medication during gestation. In the 3 months following delivery, the prevalence of antidepressant use was the same as before pregnancy (2.9%). There was no shift to benzodiazepines in the group of women who stopped taking antidepressants during pregnancy. Although paroxetine and fluoxetine were the most frequently used antidepressants among the study group, all modern antidepressants were used.
A considerable number of women are being exposed to antidepressants throughout pregnancy up until delivery. One consequence of this is that their newborns need special care and supervision during the first days of life. However, women who stop taking the medication may risk a relapse of their illness, and this may also have a negative effect on the child.
本研究旨在确定荷兰一大群女性在怀孕前、孕期及产后使用抗抑郁药的程度和模式。
分析了荷兰最大的一家健康保险公司的医疗记录和处方数据。研究队列由2000年1月至2003年7月期间分娩的29005名女性组成。特定时期内抗抑郁药的使用定义为该时期有处方记录。
在研究队列的所有孕妇中，发现2%在孕早期服用了抗抑郁药；在孕中期和孕晚期，这一数字降至所有怀孕女性的1.8%。35岁以上女性在怀孕前及孕期使用抗抑郁药的比例几乎是35岁以下女性的两倍。近60%在怀孕前使用抗抑郁药的女性在孕早期停止用药，之后停止用药的人数较少。在孕期使用抗抑郁药的所有女性中，三分之一在妊娠期开始使用这种药物。在分娩后的3个月内，抗抑郁药的使用患病率与怀孕前相同（2.9%）。在孕期停止服用抗抑郁药的女性群体中，没有转向使用苯二氮䓬类药物。虽然帕罗西汀和氟西汀是研究组中最常用的抗抑郁药，但所有现代抗抑郁药均有使用。
相当数量的女性在整个孕期直至分娩都在接触抗抑郁药。由此带来的一个后果是，她们的新生儿在出生后的头几天需要特别护理和监护。然而，停止用药的女性可能有病情复发的风险，这也可能对孩子产生负面影响。
