Article Text

Download PDFPDF
Association between the use of antidepressants and the risk of preterm birth among pregnant women with depression: a retrospective cohort study in Taiwan
  1. Li-Fen Chen1,2,
  2. Ching-En Lin3,4,
  3. Chi-Hsiang Chung5,6,
  4. Ching-Huang Lai7,
  5. Wu-Chien Chien4,5,6,7
  1. 1 Department of Psychiatry, Hualien Armed Forces General Hospital, Hualien, Taiwan
  2. 2 Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
  3. 3 Department of Psychiatry, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
  4. 4 Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
  5. 5 Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
  6. 6 Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
  7. 7 School of Public Health, National Defense Medical Center, Taipei, Taiwan
  1. Correspondence to Professor Wu-Chien Chien, Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan; chienwu{at}ndmctsgh.edu.tw; Professor Ching-Huang Lai, School of Public Health, National Defense Medical Center, Taipei, Taiwan; lgh{at}ndmctsgh.edu.tw

Abstract

Our study was aimed to investigate the association between the use of antidepressants and the risk of preterm birth in pregnant women who have had perinatal depression. We extracted data from the Taiwanese National Health Insurance Research Database (NHIRD) and analyzed them using multivariate Cox proportional hazard regression models. Identified from the NHIRD, we matched 1789 women aged 18–55 years who were using antidepressants during pregnancy and 1789 women who were experiencing depression but who were not using antidepressants during pregnancy for age, index date, and medical comorbidities. We enrolled the women in our study, which we conducted using 12 years’ worth of data between 2000 and 2012, and then followed up individually with them for up to 1 year to identify any occurrence of preterm birth. Results highlighted that, compared with the women with perinatal depression who were not using antidepressants during pregnancy, the women taking antidepressants had a 1.762-fold risk of preterm birth (adjusted HR=1.762, 95% CI 1.351 to 2.294, p<0.001). The use of antidepressants in women with perinatal depression may increase the risk of preterm birth. However, the decision to start, stop, or change the use of antidepressants during pregnancy requires evaluating the risks of treatment versus untreated depression for both mother and child.

  • mental disorders
  • medicine
  • pregnancy
  • mothers

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

Statistics from Altmetric.com

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

View Full Text

Footnotes

  • Correction notice Since Online First publication, the corresponding author's email address has been corrected to lgh@ndmctsgh.edu.tw.

  • Contributors L-FC drafted the manuscript, developed the concept, and designed the experiments. C-EL and C-HC analyzed and interpreted the data. W-CC and C-HL supervised the manuscript preparation. All authors read and approved the final manuscript.

  • Funding This study was supported in part by the Tri-Service General Hospital Research Foundation (TSGH-B-110012).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.