Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands.
BJOG. 2009 Nov;116(12):1568-77. doi: 10.1111/j.1471-0528.2009.02292.x. Epub 2009 Aug 13.
To evaluate healthcare utilisation by children who were exposed to antidepressant drug use during pregnancy and those whose mothers stopped using antidepressants before pregnancy compared with a control group.
Cohort study. Setting Health insurance records in the Netherlands.
A total of 38 602 children born between 2000 and 2005.
Survey of child healthcare utilisation in relation to gestational antidepressant use.
Healthcare utilisation rates during the first year of life, with special emphasis to medical care related to cardiac disease.
Children of mothers who used antidepressants during pregnancy showed increased healthcare use during the first year of life, independent of the mother's healthcare use. The relative risk of more than two visits to general practitioners was 1.5 (95% confidence interval, CI: 1.3-1.8) in the continuous antidepressant users group and 1.3 (95% CI: 1.2-1.5) in the group of children whose mothers stopped taking medication. In both study groups there was a trend towards more drug use for infections and inflammation compared with the control group. Children continuously exposed to antidepressants had an increased risk of cardiac interventions such as cardiovascular surgery or heart catheterisation, relative risk of 5.6 (95% CI: 1.8-17.4). The risk of physiotherapy was twice as high in the antidepressant group compared with the control group (relative risk 2.0; 95% CI: 1.5-2.6).
Antidepressant use during pregnancy is associated with increased child healthcare utilisation and increased risk of major cardiac interventions in early childhood.
评估在妊娠期间暴露于抗抑郁药物的儿童与那些母亲在妊娠前停止使用抗抑郁药物的儿童以及对照组相比，其医疗保健利用情况。
队列研究。在荷兰的医疗保险记录中进行。
2000 年至 2005 年期间出生的共 38602 名儿童。
调查与妊娠期间抗抑郁药物使用相关的儿童保健使用情况。
生命第一年的医疗保健利用率，特别关注与心脏病相关的医疗保健。
母亲在妊娠期间使用抗抑郁药物的儿童在生命的第一年表现出增加的医疗保健使用，而与母亲的医疗保健使用无关。连续使用抗抑郁药物组的儿科医生就诊次数超过两次的相对风险为 1.5（95%置信区间，CI：1.3-1.8），母亲停止服药组的相对风险为 1.3（95%CI：1.2-1.5）。在两个研究组中，与对照组相比，感染和炎症的药物使用均呈上升趋势。与对照组相比，持续暴露于抗抑郁药物的儿童有更高的心血管手术或心脏导管插入术等心脏介入治疗的风险，相对风险为 5.6（95%CI：1.8-17.4）。与对照组相比，抗抑郁药物组接受物理治疗的风险高出一倍（相对风险 2.0；95%CI：1.5-2.6）。
妊娠期间使用抗抑郁药物与儿童医疗保健利用增加以及儿童早期主要心脏介入的风险增加相关。
