Observational studyPharmacoepidemiology and drug safety2015
Methodological considerations in assessing the effectiveness of antidepressant medication continuation during pregnancy using administrative data.
Observational study in Pharmacoepidemiology and drug safety, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 37 citations in OpenAlex.
- Descriptive Characteristics of Psychiatric Medication Discontinuation Among Perinatal Women With Depressive Symptoms.Early intervention in psychiatry · 2025Trial
- Selection Biases in Perinatal Research: A Comparison of Inverse Probability Weighting, Instrumental Variable and Sibling-Comparison Design.Paediatric and perinatal epidemiology · 2026Article
- Timing of Antidepressant Discontinuation During Pregnancy and Postpartum Psychiatric Outcomes in Denmark and Norway.JAMA psychiatry · 2023Article
- Psychiatric visits during the postpartum year in women with eating disorders who continue or discontinue antidepressant treatment in pregnancy.The International journal of eating disorders · 2023Article
- Selective Serotonin Reuptake Inhibitors (SSRIs) in Pregnancy: An Updated Review on Risks to Mother, Fetus, and Child.Current psychiatry reports · 2022Review
- Treatment of Peripartum Depression with Antidepressants and Other Psychotropic Medications: A Synthesis of Clinical Practice Guidelines in Europe.International journal of environmental research and public health · 2022Review
- Antidepressant discontinuation before or during pregnancy and risk of psychiatric emergency in Denmark: A population-based propensity score-matched cohort study.PLoS medicine · 2022Article
- Antidepressant Fill and Dose Trajectories in Pregnant Women with Depression and/or Anxiety: A Norwegian Registry Linkage Study.Clinical epidemiology · 2022Article
- A surrogate measure for patient reported symptom remission in administrative data.BMC psychiatry · 2021Article
- Association between Antidepressant Treatment during Pregnancy and Postpartum Self-Harm Ideation in Women with Psychiatric Disorders: A Cross-Sectional, Multinational Study.International journal of environmental research and public health · 2020Article
- Factors associated with re-initiation of antidepressant treatment following discontinuation during pregnancy: a register-based cohort study.Archives of women's mental health · 2020Article
- Observational
- Schizophrenia around the time of pregnancy: leveraging population-based health data and electronic health record data to fill knowledge gaps.BJPsych open · 2020Article
- Use of real-world evidence from healthcare utilization data to evaluate drug safety during pregnancy.Pharmacoepidemiology and drug safety · 2019Review
- Bias in pharmacoepidemiologic studies using secondary health care databases: a scoping review.BMC medical research methodology · 2019Article
- Recurrence of depression in the perinatal period: Clinical features and associated vulnerability markers in an observational cohort.PloS one · 2019Article
- Methods for the assessment of selection bias in drug safety during pregnancy studies using electronic medical data.Pharmacology research & perspectives · 2018Article
- Patterns of antidepressant use during pregnancy: a nationwide population-based cohort study.British journal of clinical pharmacology · 2018Article
- Making fair comparisons in pregnancy medication safety studies: An overview of advanced methods for confounding control.Pharmacoepidemiology and drug safety · 2018Review
- Self-reported perinatal depressive symptoms and postnatal symptom severity after treatment with antidepressants in pregnancy: a cross-sectional study across 12 European countries using the Edinburgh Postnatal Depression Scale.Clinical epidemiology · 2018Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
Abstract
purposeThe decision whether to continue antidepressant use for depression during pregnancy requires weighing maternal and child risks and benefits. Little is known about the effectiveness of antidepressant therapy during pregnancy. The goal of this study is to evaluate whether standard administrative claims data can be used to evaluate the effectiveness of antidepressants.
methodsUsing prescription and healthcare visit Medicaid claims (2000-2007), we identified 28 493 women with a depression diagnosis and antidepressant fill in the 90 days before their last menstrual period. Antidepressant continuation was defined based on prescription fills during the first trimester. Depression hospitalizations and deliberate self-harm served as measures of the effectiveness of treatment continuation during pregnancy. Propensity score and instrumental variable analyses were used to attempt to account for confounding.
resultsRelative to women who discontinued antidepressant therapy, women who continued were more likely to have a depression inpatient stay (odds ratio [OR] = 2.2, 95% confidence interval [95%CI]: 2.0-2.4) and deliberate self-harm code (OR = 1.4, 95%CI: 0.7-2.7). Accounting for measured covariates in the propensity score analysis, including age, race, comorbidities, comedications, features of the depression diagnosis, and antidepressant class, led to slightly attenuated estimates (OR = 2.0, 95%CI: 1.8-2.2; OR = 1.1, 95%CI: 0.5-2.4). Similar associations were estimated in subgroups with different levels of baseline depression severity. Proposed preference-time, calendar-time-based, and geography-based instruments were unlikely to meet the required conditions for a valid analysis.
conclusionsOur findings suggest that either antidepressant medications do not reduce the risk of depression relapse in pregnant women, or that administrative data alone could not be used to validly estimate the effectiveness of psychotropic medications during pregnancy.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.