Bellas Lucía, Camacho-Arteaga Lina, Giner-Soriano Maria, Gómez-Lumbreras Ainhoa, Aguilera Cristina, Agustí Antonia
Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Barcelona, Spain.
Clinical Pharmacology Department, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
Drug Saf. 2025 Jul 9. doi: 10.1007/s40264-025-01576-z.
Affective disorders, particularly depression, are common among women of childbearing age, and pregnancy often exacerbates symptoms. Antidepressants are often required for treatment, but adherence during pregnancy is variable. Although some studies suggest potential risks to the foetus, many cannot rule out confounding by indication. In this context, understanding real-world patterns of antidepressant prescription and adherence during pregnancy is essential to inform clinical practice and ensure adequate mental healthcare.
The aim of the present study was to characterise the use of antidepressants in a cohort of pregnant women using electronic health records.
This observational cohort drug-utilisation study assessed antidepressant prescription patterns, adherence and persistence among pregnant women using data from the SIDIAP (Information System for the Development of Research in Primary Care) database in Catalonia from January 2011 to June 2020.
Among 99,605 pregnancies, 14.9% involved antidepressant prescriptions, but only 5.8% of these were collected from pharmacies. The median pregnancy duration was 38.4 weeks, and the median maternal age was 33.5 years. Anxiety was the most common health issue associated with an antidepressant prescription. Paroxetine was the most frequently prescribed antidepressant, although sertraline usage increased over time. Antidepressant prescriptions and adherence decreased during pregnancy, with an increase in the postpartum period. About 11.6% of pregnancies involved a concurrent prescription of another antidepressant, and 29.2% of women resumed antidepressant use after pregnancy. Women who initiated antidepressants during pregnancy were more likely to persist with treatment than those with pre-existing prescriptions.
Our study describes antidepressant use during pregnancy in Catalonia. It is remarkable that there is a notable gap between antidepressant prescriptions and dispensations. Given the risks of untreated maternal depression, strengthening primary care with adequate resources and personalised support is essential for improving perinatal mental healthcare.
情感障碍，尤其是抑郁症，在育龄女性中很常见，而怀孕往往会加重症状。治疗通常需要使用抗抑郁药，但孕期的服药依从性各不相同。尽管一些研究表明对胎儿存在潜在风险，但许多研究无法排除指征性混杂因素。在这种情况下，了解孕期抗抑郁药处方和服药依从性的真实情况对于指导临床实践和确保获得足够的精神卫生保健至关重要。
本研究的目的是利用电子健康记录对一组孕妇使用抗抑郁药的情况进行特征描述。
这项观察性队列药物利用研究使用了加泰罗尼亚2011年1月至2020年6月SIDIAP（初级保健研究发展信息系统）数据库中的数据，评估了孕妇的抗抑郁药处方模式、服药依从性和持续性。
在99,605例妊娠中，14.9%涉及抗抑郁药处方，但其中只有5.8%是从药房取药的。妊娠持续时间的中位数为38.4周，产妇年龄的中位数为33.5岁。焦虑是与抗抑郁药处方相关的最常见健康问题。帕罗西汀是最常开具处方的抗抑郁药，不过舍曲林的使用量随时间增加。抗抑郁药处方和服药依从性在孕期下降，在产后阶段增加。约11.6%的妊娠涉及同时开具另一种抗抑郁药的处方，29.2%的女性在产后恢复使用抗抑郁药。孕期开始使用抗抑郁药的女性比已有处方的女性更有可能持续接受治疗。
我们的研究描述了加泰罗尼亚孕期抗抑郁药的使用情况。抗抑郁药处方和配药之间存在显著差距，这一点值得注意。鉴于未治疗的产妇抑郁症存在风险，加强配备充足资源和个性化支持的初级保健对于改善围产期精神卫生保健至关重要。
