Evidence map›Paper›PMID 39512763›Full record

ArticleAJOG global reports2024

Association between psychopharmacotherapy and postpartum hemorrhage.

Frank I Jackson, Insaf Kouba, Natalie Meirowitz, Nathan A Keller, Luis A Bracero, Matthew J Blitz

Abstract read
In one paragraph

Article in AJOG global reports, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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.

Frank I JacksonNorthwell, New Hyde Park, NY (Jackson, Kouba, Meirowitz, Keller, Bracero, and Blitz).
Insaf KoubaNorthwell, New Hyde Park, NY (Jackson, Kouba, Meirowitz, Keller, Bracero, and Blitz).
Natalie MeirowitzNorthwell, New Hyde Park, NY (Jackson, Kouba, Meirowitz, Keller, Bracero, and Blitz).
Nathan A KellerNorthwell, New Hyde Park, NY (Jackson, Kouba, Meirowitz, Keller, Bracero, and Blitz).
Luis A BraceroNorthwell, New Hyde Park, NY (Jackson, Kouba, Meirowitz, Keller, Bracero, and Blitz).
Matthew J BlitzNorthwell, New Hyde Park, NY (Jackson, Kouba, Meirowitz, Keller, Bracero, and Blitz).

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Prior studies evaluating the relationship between psychopharmacotherapy (PPT), and postpartum hemorrhage (PPH) have yielded inconsistent findings. Clarifying this potential relationship is important for effective counseling and risk stratification. Objectives: Our primary objective was to evaluate the association between prenatal exposure to PPT (any drug class) and the occurrence of PPH requiring transfusion of packed red blood cells (PPH+pRBC) after systematically adjusting for known hemorrhage risk factors at the time of admission for delivery. Secondary objectives were to evaluate the association between individual PPT drug classes and PPH+pRBC, and the association between treatment intensity of mental health condition and PPH+pRBC. Finally, we evaluated the association between PPT and a broader definition of PPH that included deliveries requiring multiple uterotonic drugs. Study design: This is a retrospective cross-sectional study of all pregnancies delivered at 23 weeks of gestational age or greater at seven hospitals within a large academic health system in New York between January 2019 and December 2022. There were no exclusion criteria, as postpartum hemorrhage risk assessment is necessary for all patients admitted for delivery. We assessed exposure to prenatal PPT, including selective serotonin reuptake inhibitors (SSRIs: escitalopram, fluoxetine, sertraline), serotonin-norepinephrine reuptake inhibitors (SNRIs: duloxetine, venlafaxine), dopamine-norepinephrine reuptake inhibitors (DNRIs: buproprion), benzodiazepines (alprazolam, diazepam, lorazepam), and others (buspirone, trazodone, zolpidem). Multivariable logistic regression was performed to evaluate the relationship between PPT and PPH+pRBC, while systematically adjusting for known hemorrhage risk factors at the time of hospital admission. Similar regression analyses were performed to address the secondary objectives. Results: A total of 107,425 deliveries were included. Non-Hispanic White patients constituted the largest race and ethnicity group (43.4%), followed by Hispanic patients (18.7%), Asian or Pacific Islander patients (13.2%), and non-Hispanic Black patients (12.3%). Prenatal exposure to PPT occurred in 3.6% of pregnancies ( Conclusions: Prenatal PPT exposure is associated with increased odds of clinically significant PPH+pRBC after adjusting for other hemorrhage risk factors. Combination PPT was associated with greater odds of PPH+pRBC than monotherapy.

Indexed as

benzodiazepinebleeding risk assessmentdopamine-norepinephrine reuptake inhibitorsmental health conditionperinatal mood disorderselective serotonin reuptake inhibitorsserotonin-norepinephrine reuptake inhibitors

Identifiers

PMID39512763
PMCPMC11541838

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Registered trials

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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.