Maternal Gestational Weight Gain in Relation to Antidepressant Continuation in Pregnancy.
Maternal Gestational Weight Gain in Relation to Antidepressant Continuation in Pregnancy.
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DOI：
10.1055/s-0040-1713652
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发表时间：
2021-11
影响因子：
2
通讯作者：
Dublin S
中科院分区：
文献类型：
--
作者：
Wartko PD;Weiss NS;Enquobahrie DA;Chan KCG;Stephenson-Famy A;Mueller BA;Dublin S
妊娠期体重增加过多和不足都与妇女及其孩子的不良健康结果有关。怀孕期间使用抗抑郁药可能会影响妊娠期体重增加，根据非怀孕妇女的证据，一些抗抑郁药可能会导致体重增加，而另一些则会导致体重减轻。以前关于抗抑郁药使用和妊娠期体重增加的研究很少，解释混杂因素的能力有限，包括母亲的精神健康状况和严重程度。我们评估了妊娠前使用抗抑郁药的妇女妊娠期继续服用抗抑郁药与妊娠期体重增加的关系。我们的回顾性队列研究包括2001-2014年在Kaiser Permanente Washington（一个综合医疗系统）内的单胎活产。数据是从电子健康记录和华盛顿州出生记录中获得的。在孕前6个月内服用抗抑郁药≥1种的妇女中，怀孕期间服用抗抑郁药的妇女被认为是“继续服用”；没有填充物的妇女被称为“停产者”。我们根据医学研究所的指南计算了妊娠期体重增加和体重增加不足和过度的相对风险（RR）的平均差异。使用广义估计方程的治疗加权逆概率，我们解决了产妇特征的差异，包括心理健康状况。在2887名新生儿中，1689名（59%）的母亲在怀孕期间继续服用抗抑郁药物，1198名（42%）的母亲已停用抗抑郁药物。在考虑混杂因素后，继续治疗的患者体重增加与停止治疗的患者相似（平均差异：1.3磅，95%可信区间[CI]: - 0.1, 2.8磅），妊娠期体重增加不足和过度的风险相似（RR: 0.95, 95% CI: 0.80, 1.14, RR: 1.06, 95% CI: 0.98, 1.14）。研究结果与特定抗抑郁药和暴露的三个月相当。我们没有发现妊娠期继续服用抗抑郁药导致妊娠期体重增加差异的证据。
Both excessive and inadequate gestational weight gain are associated with adverse health outcomes for the woman and her child. Antidepressant use in pregnancy may affect gestational weight gain, based on evidence in non-pregnant women that some antidepressants may cause weight gain and others weight loss. Previous studies of antidepressant use and gestational weight gain were small with limited ability to account for confounding, including by maternal mental health status and severity. We assessed the association of antidepressant continuation in pregnancy with gestational weight gain among women using antidepressants before pregnancy. Our retrospective cohort study included singleton live births from 2001–2014 within Kaiser Permanente Washington, an integrated healthcare system. Data were obtained from electronic health records and linked Washington State birth records. Among women with ≥1 antidepressant fill within 6 months before pregnancy, women who filled an antidepressant during pregnancy were considered “continuers”; women without a fill were “discontinuers”. We calculated mean differences in gestational weight gain and relative risks (RR) of inadequate and excessive weight gain based on Institute of Medicine guidelines. Using inverse probability of treatment weighting with generalized estimating equations, we addressed differences in maternal characteristics, including mental health conditions. Among the 2,887 births, 1,689 (59%) were to women who continued antidepressants in pregnancy and 1,198 (42%) were to discontinuers. After accounting for confounding, continuers had similar weight gain to those who discontinued (mean difference: 1.3 lbs, 95% confidence interval [CI]: −0.1, 2.8 lbs) and similar risks of inadequate and excessive gestational weight gain (RR: 0.95, 95% CI: 0.80, 1.14 and RR: 1.06, 95% CI: 0.98, 1.14, respectively). Findings were comparable for specific antidepressants and trimesters of exposure. We did not find evidence that continuation of antidepressants in pregnancy led to differences in gestational weight gain.
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作者：
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通讯作者：
National Birth Defects Prevention Study
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