Dupuis Marc, Weir Kristie Rebecca, Vidonscky Lüthold Renata, Panchaud Alice, Baggio Stéphanie
Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, Bern, 3012, Switzerland.
Graduate School for Health Sciences (GHS), University of Bern, Bern, Switzerland.
Arch Womens Ment Health. 2024 Dec;27(6):1011-1018. doi: 10.1007/s00737-024-01470-0. Epub 2024 May 14.
Patients and healthcare professionals overestimate the risks of using antidepressants during pregnancy. According to current literature, approximately half of people stop taking an anti-depressant medication when they become pregnant. Discontinuing antidepressants during pregnancy increases risks of postnatal relapses. Factors like socioeconomic status, education, and planned pregnancies play a role in the decision to continue antidepressant medication, which can worsen disparities in maternal and child health. Our aim was to identify the sociodemographic factors associated with antidepressant continuation after awareness of pregnancy.
We used representative data from the Adolescent Brain Cognitive Development (ABCD) study that captures maternal medication during pregnancy. We identified women who used antidepressants before awareness of their pregnancy. We calculated crude and adjusted associations between sociodemographic factors and continuation of antidepressant medication during pregnancy. Our model included age, education, ethnicity, first language, household income, living with a partner, having planned the pregnancy, pregnancy duration and smoking during pregnancy.
In total, 199 women continued antidepressants and 100 discontinued. The logistic regressions resulted in only one significant factor: first language. Native English speakers were more likely to continue medication than other mothers (adjusted OR = 14.94, 95% CI = [2.40; 291.45], p = .015).
Language differences were associated with continuation of antidepressants. Non-native English speakers were more likely to discontinue antidepressants, which may lead to health inequities. This finding should be taken into account to reinforce information about the limited risks of antidepressants among people with non-English speaking backgrounds in the USA.
患者和医疗保健专业人员高估了孕期使用抗抑郁药的风险。根据当前文献，大约一半的人在怀孕时会停止服用抗抑郁药物。孕期停用抗抑郁药会增加产后复发的风险。社会经济地位、教育程度和计划内怀孕等因素在决定是否继续服用抗抑郁药物方面发挥着作用，这可能会加剧母婴健康方面的不平等。我们的目的是确定在知晓怀孕后与继续使用抗抑郁药相关的社会人口学因素。
我们使用了青少年大脑认知发展（ABCD）研究中的代表性数据，该研究记录了孕期母亲用药情况。我们确定了在知晓怀孕前使用抗抑郁药的女性。我们计算了社会人口学因素与孕期继续使用抗抑郁药物之间的粗略关联和调整后的关联。我们的模型包括年龄、教育程度、种族、母语、家庭收入、与伴侣同住、计划内怀孕、怀孕时长和孕期吸烟情况。
共有199名女性继续服用抗抑郁药，100名停药。逻辑回归仅得出一个显著因素：母语。以英语为母语的人比其他母亲更有可能继续用药（调整后的比值比=14.94，95%置信区间=[2.40；291.45]，p=0.015）。
语言差异与继续使用抗抑郁药有关。非英语母语者更有可能停用抗抑郁药，这可能导致健康不平等。在美国，对于非英语背景的人群，应考虑这一发现，以强化关于抗抑郁药风险有限的信息。
