Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University , Shenyang, P.R. China .
J Womens Health (Larchmt). 2018 Jun;27(6):791-800. doi: 10.1089/jwh.2017.6642. Epub 2018 Feb 28.
To analyze existing cohort studies and provide evidence for the use of prenatal selective serotonin reuptake inhibitor (SSRI) monotherapy and the associated risk of gestational hypertension and preeclampsia.
A comprehensive search of English language articles published before 30th April 2017 was conducted on PubMed, EMBASE, and the Web of Science databases. Using data acquired, we summarized the relative risks (RRs) and 95% confidence intervals (CIs) of gestational hypertension and preeclampsia using the random-effects model. Heterogeneity between studies was also assessed with the I statistic.
Seven cohort studies with 1,108,261 individuals were included for analysis. Compared with nonusers, those undertaking prenatal SSRI monotherapy were more likely to develop gestational hypertension or preeclampsia (summarized RR = 1.21, 95% CI: 1.05-1.40, I = 71.3%), gestational hypertension (summarized RR = 1.14, 95% CI: 1.00-1.30, I = 5.7%), and preeclampsia (summarized RR = 1.32, 95% CI: 0.99-1.78, I = 83.3%). In addition, although subgroup analyses, which were stratified by study design, number of cases, geographic location, duration of SSRI monotherapy, registry databases, and adjustment for potential confounders and risk factors, were consistent with the main findings, not all of these showed statistical significance. No evidence of publication bias was detected.
Women who receive SSRI monotherapy during pregnancy are at increased risk of gestational hypertension and preeclampsia.
分析现有的队列研究，为产前选择性 5-羟色胺再摄取抑制剂（SSRI）单药治疗的应用及其与妊娠期高血压和子痫前期的相关性风险提供证据。
在 PubMed、EMBASE 和 Web of Science 数据库中对截至 2017 年 4 月 30 日之前发表的英文文献进行全面检索。利用获得的数据，采用随机效应模型汇总妊娠期高血压和子痫前期的相对风险（RR）和 95%置信区间（CI）。同时，采用 I ² 统计量评估研究间的异质性。
纳入 7 项队列研究，共 1108261 例个体。与未使用者相比，接受产前 SSRI 单药治疗的孕妇更易发生妊娠期高血压或子痫前期（汇总 RR=1.21，95%CI：1.05-1.40，I=71.3%）、妊娠期高血压（汇总 RR=1.14，95%CI：1.00-1.30，I=5.7%）和子痫前期（汇总 RR=1.32，95%CI：0.99-1.78，I=83.3%）。此外，尽管按研究设计、病例数、地理位置、SSRI 单药治疗持续时间、登记数据库以及对潜在混杂因素和危险因素的调整进行亚组分析的结果与主要发现一致，但并非所有结果均具有统计学意义。未发现发表偏倚的证据。
妊娠期间接受 SSRI 单药治疗的女性发生妊娠期高血压和子痫前期的风险增加。
