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孕期服用抗抑郁药的女性从医疗保健提供者及其他人那里获得的非循证信息的负面影响。

Negative impact of non-evidence-based information received by women taking antidepressants during pregnancy from health care providers and others.

作者信息

Mulder Eva, Davis Amy, Gawley Laura, Bowen Angela, Einarson Adrienne

机构信息

The Motherisk Program, The Hospital for Sick Children, Toronto ON.

College of Nursing, University of Saskatchewan, Saskatoon SK.

出版信息

J Obstet Gynaecol Can. 2012 Jan;34(1):66-71. doi: 10.1016/S1701-2163(16)35136-2.

Abstract

OBJECTIVES

The use of antidepressants by women during pregnancy continues to be a controversial subject, with conflicting information regarding the safety of this group of drugs. We sought (1) to determine the impact of information, advice, and comments women received from health care providers, family, and media about use of antidepressants during pregnancy, and (2) to compare experiences regarding the psychosocial impact of women who continued and discontinued antidepressant therapy during pregnancy.

METHODS

Women who had taken an antidepressant at some point during pregnancy were interviewed. The responses of women who continued antidepressant therapy throughout pregnancy were compared with those of women who discontinued therapy at some point in the pregnancy. A questionnaire with questions pertaining to information women had received from various individuals regarding the use of an antidepressant while pregnant was administered to both groups.

RESULTS

Ninety-four interviews were completed; 78 were with women who continued antidepressant therapy throughout pregnancy, and 16 were with women who discontinued therapy. The small number of women in the discontinuation group was a result of many women declining to participate. More than one half of the women who continued the medication throughout pregnancy had frequently considered discontinuing, despite reassurance that continuation would cause no harm to their baby. Negative information was recalled far more often than reassuring information.

CONCLUSION

Information from friends, family, and health care providers can have a negative impact on decision-making regarding pharmacotherapy for depression during pregnancy. Health care providers should be cognizant of this when counselling patients who require antidepressant therapy during pregnancy.

摘要

目的

孕期女性使用抗抑郁药仍是一个有争议的话题,关于这类药物的安全性存在相互矛盾的信息。我们旨在(1)确定女性从医疗保健提供者、家人和媒体处获得的关于孕期使用抗抑郁药的信息、建议和评论的影响,以及(2)比较孕期持续和停止抗抑郁治疗的女性在心理社会影响方面的经历。

方法

对在孕期某个阶段服用过抗抑郁药的女性进行访谈。将整个孕期持续进行抗抑郁治疗的女性的回答与在孕期某个时间点停止治疗的女性的回答进行比较。向两组女性发放了一份问卷,问卷中的问题涉及女性从不同个体处获得的关于孕期使用抗抑郁药的信息。

结果

完成了94次访谈;78次是与整个孕期持续进行抗抑郁治疗的女性进行的,16次是与停止治疗的女性进行的。停止治疗组的女性人数较少是因为许多女性拒绝参与。在整个孕期持续服药的女性中,超过一半的人经常考虑停药,尽管得到保证继续服药不会对胎儿造成伤害。负面信息的回忆频率远远高于安慰性信息。

结论

朋友、家人和医疗保健提供者提供的信息可能会对孕期抑郁症药物治疗的决策产生负面影响。医疗保健提供者在为孕期需要抗抑郁治疗的患者提供咨询时应意识到这一点。

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