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Antidepressant medication use, depression, and the risk of preeclampsia

Published online by Cambridge University Press:  17 March 2015

Lyndsay Ammon Avalos ,
Hong Chen  and
De-Kun Li
Lyndsay Ammon Avalos*
Affiliation:
Kaiser Permanente Northern California, Division of Research, Oakland, California, USA
Hong Chen
Affiliation:
Kaiser Permanente Northern California, Division of Research, Oakland, California, USA
De-Kun Li
Affiliation:
Kaiser Permanente Northern California, Division of Research, Oakland, California, USA
*
*Address for correspondence: Lyndsay Ammon Avalos, Kaiser Permanente Northern California, Division of Research, 2000 Broadway, Oakland, CA 94612, USA. (Email: [email protected])
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Abstract

Objective

To assess the effects of depression and antidepressant medication use during pregnancy on the risk of preeclampsia.

Methods

We conducted a retrospective, population-based cohort study that linked automated clinical and pharmacy databases including comprehensive electronic medical records of 21,589 pregnant Kaiser Permanente Northern California members between 2010 and 2012.

Results

The overall risk of preeclampsia was 4.5%. The timing of antidepressant medication exposure was an important factor. A significant increase in the risk of preeclampsia emerged for women with a depression diagnosis who took antidepressant medications during the second trimester compared to women with untreated depression (adjusted relative risk [aRR]: 1.6, 95% CI: 1.06, 2.39) and to women without depression (aRR: 1.70, 95% CI: 1.30, 2.23). Similar associations existed for women who took antidepressant medications, but without depression. In contrast, depressed women with psychotherapy showed no increased risk of preeclampsia compared to women with untreated depression or no depression. There was also a statistically significant relationship between the duration of antidepressant medication use and preeclampsia. The observed association appeared stronger for selective serotonin reuptake inhibitor (SSRI) use, although a nonsignificant trend was also noted for use of norepinephrine-dopamine reuptake inhibitors (NDRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs).

Conclusion

Study findings suggest that antidepressant use during pregnancy may increase the risk of preeclampsia, especially use during the second trimester.

Keywords

Antidepressantsclass of antidepressantdepressionpreeclampsiapregnancy outcomes
Type
Original Research
Information
CNS Spectrums , Volume 20 , Issue 1 , February 2015 , pp. 39 - 47
Copyright
© Cambridge University Press 2015 

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Footnotes

*

This project was funded by a grant awarded to Lyndsay A. Avalos by Kaiser Permanente Community Benefits. Lyndsay A. Avalos’s time was also partially funded by UCSF-Kaiser/DOR Building Interdisciplinary Research Careers in Women’s Health Program (K12HD052163, NICHD/NIH, Guglielmo, PI).

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