Chang Qing, Ma Xiao-Yu, Xu Xin-Rui, Su Han, Wu Qi-Jun, Zhao Yu-Hong
Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China.
Front Pharmacol. 2020 May 19;11:659. doi: 10.3389/fphar.2020.00659. eCollection 2020.
The associations between maternal use of antidepressant during pregnancy and preterm birth (PTB) has been the subject of much discussion and controversy. The aim of the present study was to systematically review the association between antidepressant use during pregnancy and the risk of PTB, especially in depressed women.
A computerized search was conducted in PubMed, PsycINFO, and Embase before , supplemented with a manual search of the reference lists, to identify original research regarding PTB rates in women taking antidepressants during pregnancy. A random-effects model was used to calculate the summarized relative risks (RRs) and 95% confidence intervals (CIs). The potential for publication bias was examined through Begg' s and Egger' s tests.
A total of 2,279 articles were reviewed, 23 of which were selected. The risk of PTB was increased in women with depression [1.58 (1.23-2.04)] and in the general pregnant female population [1.35 (1.11-1.63)] who used antidepressants during pregnancy. Similar results were observed in depressed women treated with selective serotonin reuptake inhibitors (SSRIs) during pregnancy [1.46 (1.32-1.61)]. There was no significantly increased risk of PTB observed with SSRI use in the general pregnant female population [1.25 (1.00-1.57)], and the heterogeneity of these studies was high.
The results of this meta-analysis indicate maternal antidepressant use is associated with a significantly increased risk of PTB in infants. Health care providers and pregnant women must weigh the risk-benefit potential of these drugs when making decisions about whether to treat with antidepressant during pregnancy.
孕期母亲使用抗抑郁药与早产（PTB）之间的关联一直是诸多讨论和争议的主题。本研究的目的是系统回顾孕期使用抗抑郁药与PTB风险之间的关联，尤其是在抑郁症女性中。
在PubMed、PsycINFO和Embase数据库中进行计算机检索，并辅以对参考文献列表的手动检索，以确定关于孕期服用抗抑郁药女性的PTB发生率的原始研究。采用随机效应模型计算汇总相对风险（RRs）和95%置信区间（CIs）。通过Begg检验和Egger检验检查发表偏倚的可能性。
共检索了2279篇文章，其中23篇被选中。抑郁症女性[1.58（1.23 - 2.04）]以及孕期使用抗抑郁药的普通怀孕女性人群[1.35（1.11 - 1.63）]中PTB风险增加。孕期接受选择性5-羟色胺再摄取抑制剂（SSRIs）治疗的抑郁症女性中也观察到类似结果[1.46（1.32 - 1.61）]。在普通怀孕女性人群中，使用SSRI未观察到PTB风险显著增加[1.25（1.00 - 1.57）]，且这些研究的异质性较高。
这项荟萃分析的结果表明，母亲使用抗抑郁药与婴儿PTB风险显著增加有关。医疗保健提供者和孕妇在决定孕期是否使用抗抑郁药治疗时，必须权衡这些药物的潜在风险和益处。
