De Ocampo Maria P G, Araneta Maria Rosario G, Macera Caroline A, Alcaraz John E, Moore Thomas R, Chambers Christina D
University of California, La Jolla, San Diego, California, USA.
San Diego State University, San Diego, California, USA.
Arch Womens Ment Health. 2016 Dec;19(6):1051-1061. doi: 10.1007/s00737-016-0655-z. Epub 2016 Aug 24.
This study aimed to examine the association between discontinued and continued use of antidepressants and risk for gestational hypertension (GH) and preeclampsia (PE).
Data from the MotherToBaby pregnancy studies from 2004 to 2014 were analyzed to compare women who discontinued antidepressant use ˂20 weeks of gestation (discontinuers) and women who continued antidepressant use ≥20 weeks of gestation (continuers) to non-users for risk of GH (blood pressure ≥140/90 mmHg on two or more occasions at ≥20 weeks of gestation) and PE (GH with proteinuria). Maternal data, including exposures and study outcomes, were collected through multiple phone interviews. Medical records were used to validate outcomes. Odds ratios (ORs) and 95 % confidence intervals were estimated using logistic regression. Risk for GH and PE were also assessed within antidepressant drug classes.
Data from 3471 women were analyzed. Continuers were significantly at risk for GH (adjusted odds ratios (aOR) 1.83; 95 % CI 1.05, 3.21) after adjustment. Analyses by drug class showed that continued use of serotonin-norepinephrine reuptake inhibitors (SNRI) increased risk for GH; however, of the 21 women who continued to use SNRI, only 3 developed GH. Continuers who used two or more antidepressant drug classes had increased risk for PE. Selective serotonin reuptake inhibitors or other antidepressant use was not associated with increased risk for GH or PE. No significant associations with PE or GH were found for discontinuers.
Results suggest that women who continued to use antidepressants in the second half of pregnancy are at risk for GH and PE. No significant association was found among discontinuers.
本研究旨在探讨停用和继续使用抗抑郁药与妊娠期高血压（GH）和先兆子痫（PE）风险之间的关联。
分析2004年至2014年母婴妊娠研究的数据，比较妊娠<20周停用抗抑郁药的女性（停用者）、妊娠≥20周继续使用抗抑郁药的女性（继续使用者）与未使用者发生GH（妊娠≥20周时两次或更多次血压≥140/90 mmHg）和PE（伴有蛋白尿的GH）的风险。通过多次电话访谈收集产妇数据，包括暴露情况和研究结果。使用医疗记录验证结果。采用逻辑回归估计比值比（OR）和95%置信区间。还在抗抑郁药物类别中评估了GH和PE的风险。
分析了3471名女性的数据。调整后，继续使用者发生GH的风险显著增加（调整后的比值比[aOR]为1.83；95%置信区间为1.05, 3.21）。按药物类别分析显示，继续使用5-羟色胺-去甲肾上腺素再摄取抑制剂（SNRI）会增加GH风险；然而，在21名继续使用SNRI的女性中，只有3人发生了GH。使用两种或更多抗抑郁药物类别的继续使用者发生PE的风险增加。选择性5-羟色胺再摄取抑制剂或其他抗抑郁药的使用与GH或PE风险增加无关。未发现停用者与PE或GH有显著关联。
结果表明，妊娠后半期继续使用抗抑郁药的女性有发生GH和PE的风险。未发现停用者之间有显著关联。
