Esposito Giovanna, Cantarutti Anna, Lupattelli Angela, Franchi Matteo, Corrao Giovanni, Parazzini Fabio
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy.
Front Pharmacol. 2024 Mar 27;15:1325381. doi: 10.3389/fphar.2024.1325381. eCollection 2024.
Preterm birth may affect maternal mental health. We explored the relationship between preterm birth and the risk of initiating antidepressant use during the year after birth.
We conducted a population-based investigation using regional healthcare utilization databases. The exposure considered was preterm birth. The outcome was having at least one prescription for antidepressant medications during the year after birth. We used a log-binomial regression model including terms for maternal age at birth, nationality, educational level, parity, modality of conception, modality of delivery, use of other psychotropic drugs, and diabetes to estimate relative risk (RR) and 95% confidence intervals (CI) for the association between preterm birth and the initiation of antidepressant use. In addition, the absolute risk differences (ARD) were also computed according to the timing of birth.
The cohort included 727,701 deliveries between 2010 and 2020 in Lombardy, Northern Italy. Out of these, 6,522 (0.9%) women had at least one prescription for antidepressant drugs during the year after birth. Preterm births were related to a 38% increased risk of initiation of antidepressant use during the year after birth (adjusted RR = 1.38; 95% CI: 1.25-1.52) for moderate to late preterm and to 83% (adjusted RR = 1.83; 95% CI: 1.46-2.28) for extremely and very preterm. Excluding women with only one antidepressant prescription, the association was consistent (adjusted RR = 1.41, 95%CI: 1.23-1.61 for moderate to late preterm and adjusted RR = 1.81, 95% CI: 1.31-2.49 for extremely and very preterm). Also, excluding women who used other psychotropics, the association remained consistent (adjusted RR = 1.39, 95%CI: 1.26-1.54 and adjusted RR = 1.91, 95% CI: 1.53-2.38, respectively for moderate to late and extremely and very preterm).
Women who delivered preterm may have an excess risk of initiation of antidepressant consumption during the first year after birth.
早产可能会影响产妇的心理健康。我们探讨了早产与产后一年内开始使用抗抑郁药风险之间的关系。
我们利用地区医疗保健利用数据库进行了一项基于人群的调查。所考虑的暴露因素是早产。结局是产后一年内至少有一张抗抑郁药物处方。我们使用对数二项回归模型，纳入产妇分娩时的年龄、国籍、教育水平、产次、受孕方式、分娩方式、其他精神药物的使用情况以及糖尿病等因素，以估计早产与开始使用抗抑郁药之间关联的相对风险（RR）和95%置信区间（CI）。此外，还根据出生时间计算了绝对风险差异（ARD）。
该队列包括2010年至2020年期间意大利北部伦巴第地区的727,701例分娩。其中，6,522名（0.9%）女性在产后一年内至少有一张抗抑郁药物处方。中度至晚期早产与产后一年内开始使用抗抑郁药的风险增加38%相关（调整后RR = 1.38；95% CI：1.25 - 1.52），极早产和超早产则与风险增加83%相关（调整后RR = 1.83；95% CI：1.46 - 2.28）。排除仅开具一张抗抑郁药处方的女性后，这种关联仍然一致（中度至晚期早产调整后RR = 1.41，95%CI：1.23 - 1.61；极早产和超早产调整后RR = 1.81，95% CI：1.31 - 2.49）。此外，排除使用其他精神药物的女性后，这种关联仍然一致（中度至晚期早产调整后RR = 1.39，95%CI：1.26 - 1.54；极早产和超早产调整后RR = 1.91，95% CI：1.53 - 2.38）。
早产产妇在产后第一年开始使用抗抑郁药的风险可能更高。
