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孕期使用抗抑郁药:EFEMERIS 队列中的一项法国药物利用研究。

Antidepressants during pregnancy: a French drug utilisation study in EFEMERIS cohort.

机构信息

Laboratoire de Pharmacologie Médicale et Clinique, Centre Midi-Pyrénées de PharmacoVigilance, de Pharmacoépidémiologie et d'Information sur le Médicament, INSERM/UPS UMR 1027, CIC INSERM 1436, Faculté de Médecine de l'Université Paul-Sabatier et Centre Hospitalier Universitaire, 37 allées Jules Guesde, 31000, Toulouse, France.

Université Bordeaux, Inserm, CHU Bordeaux, Service de Pharmacologie Médicale, Bordeaux Population Health Research Center, Team Pharmacoepidemiology, UMR 1219, Bordeaux, France.

出版信息

Eur Arch Psychiatry Clin Neurosci. 2019 Oct;269(7):841-849. doi: 10.1007/s00406-018-0906-2. Epub 2018 May 26.

Abstract

BACKGROUND

Previous studies have suggested that exposure to some antidepressants (AD) during pregnancy could be associated with an increased risk of congenital malformations and neurodevelopment disorders for the child. We conducted a study to describe the use of AD during pregnancy in France.

METHODS

We performed a drug utilisation study in EFEMERIS, a French cohort of pregnant women. At the time of the present study, 89,170 pregnant women, who were pregnant from 2005 to 2014 in Haute-Garonne were included. Prevalence and incidence of AD prescriptions during pregnancy, characteristics of AD users, and trends in AD use over the 10-year period were studied.

RESULTS

During the 10-year study period, 1620 women registered in EFEMERIS (1.8%) received at least one prescription and dispensation for AD during pregnancy: 1363 during the first (1.5%), 591 during the second (0.7%), and 412 during the third (0.5%) trimester. A total of 2874 women (3.2%) got a prescription for an AD during the 3 months before and/or during pregnancy; 2187 of them (76.1%) stopped AD before pregnancy or during the first trimester. Selective serotonin reuptake inhibitors represented the most prescribed class during pregnancy (1.3%). A very slight decrease in the prevalence of AD prescriptions in pregnant women over time (1.7% in 2014 vs 2% in 2005) and some variations within classes were observed.

CONCLUSIONS

Nearly, 2% of women received antidepressant drugs during pregnancy. This assessment encourages following research on these drugs including the potential risk of neurodevelopmental disorders in children after an exposure to antidepressants during pregnancy.

摘要

背景

先前的研究表明,孕妇接触某些抗抑郁药(AD)可能会增加孩子先天性畸形和神经发育障碍的风险。我们进行了一项研究,以描述法国孕妇怀孕期间使用 AD 的情况。

方法

我们在 EFEMERIS 中进行了一项药物利用研究,EFEMERIS 是法国孕妇队列。在本研究时,纳入了来自上加龙省 2005 年至 2014 年期间怀孕的 89170 名孕妇。研究了怀孕期间 AD 处方的流行率和发生率、AD 使用者的特征以及 10 年来 AD 使用的趋势。

结果

在 10 年的研究期间,EFEMERIS 中有 1620 名女性(1.8%)至少收到了一份 AD 处方:1363 份在第一孕期(1.5%),591 份在第二孕期(0.7%),412 份在第三孕期(0.5%)。共有 2874 名女性(3.2%)在怀孕前 3 个月和/或怀孕期间收到了 AD 处方;其中 2187 名(76.1%)在怀孕前或第一孕期停止了 AD。怀孕期间最常开的药物类别是选择性 5-羟色胺再摄取抑制剂(SSRIs)(1.3%)。随着时间的推移,孕妇中 AD 处方的流行率略有下降(2014 年为 1.7%,2005 年为 2%),并且在各个类别内也观察到了一些变化。

结论

近 2%的孕妇接受了抗抑郁药物治疗。这种评估鼓励对这些药物进行后续研究,包括在怀孕期间接触抗抑郁药后儿童神经发育障碍的潜在风险。

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