Evidence map›Paper›PMID 36482347›Full record

ArticleBMC pregnancy and childbirth2022

Does lack of exposure to individual antidepressants at different points during pregnancy associate with reduced risk of adverse newborn outcomes?

Margaret A Tharp, Rebecca M Silvola, Claire Marks, Evgennia Teal, Sara K Quinney, David M Haas

Open access · goldAbstract read
In one paragraph

Article in BMC pregnancy and childbirth, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.4field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Margaret A TharpDepartment of Obstetrics and Gynecology, Indiana University School of Medicine, 550 N. University Blvd, UH 2440, Indianapolis, IN, 46033, USA.
Rebecca M SilvolaDepartment of Medicine, Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, IN, USA.
Claire MarksDepartment of Obstetrics and Gynecology, Indiana University School of Medicine, 550 N. University Blvd, UH 2440, Indianapolis, IN, 46033, USA.
Evgennia TealRegenstrief Institute, Indianapolis, IN, USA.
Sara K QuinneyDepartment of Obstetrics and Gynecology, Indiana University School of Medicine, 550 N. University Blvd, UH 2440, Indianapolis, IN, 46033, USA.
David M HaasDepartment of Obstetrics and Gynecology, Indiana University School of Medicine, 550 N. University Blvd, UH 2440, Indianapolis, IN, 46033, USA. dahaas@iu.edu.
Indiana University School of MedicineIndiana University – Purdue University Indianapolis · USRegenstrief Institute · US

Funding

NIGMS NIH HHS T32GM842528
6 · The paper itself

Abstract

backgroundThe objective of this study was to determine if the lack of exposure to individual antidepressants at certain times in pregnancy improved maternal and infant outcomes.

methodsThis was a retrospective cohort study of 2741 pregnant women prescribed antidepressant(s) before or during pregnancy. Data were obtained from electronic medical records. Analysis was limited to women prescribed one of five antidepressants (bupropion, citalopram, escitalopram, fluoxetine, sertraline). Period of exposure was determined using prescription order dates. Primary outcomes were neonatal intensive care unit (NICU) admission and adaptation syndrome in the newborn. Logistic regression, adjusted for maternal age, race, and insurance, compared consistent exposure throughout pregnancy versus (A) no exposure in the third trimester, (B) no exposure early in pregnancy, and (C) exposure in the midtrimester alone.

resultsCompared to women prescribed an antidepressant continually throughout pregnancy, NICU admission was less likely for women lacking exposure in the third trimester if they had been taking bupropion (aOR 0.43, 95% CI 0.21-0.90) or escitalopram (aOR 0.49, 95% CI 0.28-0.85). Women previously taking escitalopram but lacking third trimester exposure also had lower odds of adaptation syndrome (aOR 0.19, 95% CI 0.07-0.48). No differences were found in other outcomes for women taking other antidepressants or for any outcomes for women who lacked early pregnancy drug exposure compared to exposure throughout pregnancy.

conclusionFor the five antidepressants included in this study, lack of exposure early or late in pregnancy compared to consistent exposure throughout pregnancy generally did not change newborn outcomes. The exceptions were bupropion and escitalopram, where lack of exposure in the third trimester associated with lower rates of adaptation syndrome or NICU admission. These data may help pregnant women with depression in need of drug therapy to have informed discussions with providers about the potential risks and benefits to continuing or stopping drugs at different times during pregnancy.

Indexed as

FamilyFemaleHumansInfant, NewbornPregnancyRetrospective StudiesAdaptation syndromeAntidepressantsNewborn intensive care unit admissionPregnancyTrimester

Identifiers

PMID36482347
PMCPMC9733325
OpenAlexW4311587634

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.