Association between antidepressant drug use during pregnancy and child healthcare utilisation - - BJOG: An International Journal of Obstetrics & Gynaecology

maternal medicine
Association between antidepressant drug use during pregnancy and child healthcare utilisation
TF Ververs a,b , K van Wensen c , MW Freund d , M van der Heide e , GHA Visser e , AFAM Schobben a,b , LTW de Jong-van den Berg f , ACG Egberts a,b
a Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands b Department of Clinical Pharmacy, University Medical Center Utrecht, Utrecht, The Netherlands c VGZ Health Insurance Company, Nijmegen, The Netherlands d Department of Pediatric Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands e Department of Perinatology and Gynaecology, University Medical Center Utrecht, Utrecht, The Netherlands f Department of Pharmacy, Unit Pharmacoepidemiology and Pharmacoeconomics, University of Groningen, Utrecht, The Netherlands

Correspondence to ACG Egberts, Department of Clinical Pharmacy, University Medical Center Utrecht, D00.218, PO Box 85500, 3508 GA Utrecht, The Netherlands. Email a.c.g.egberts@umcutrecht.nl
Copyright Journal compilation © 2009 RCOG

KEYWORDS
Antidepressants cardiac intervention healthcare utilisation paediatrics physiotherapy pregnancy
Please cite this paper as: Ververs T, van Wensen K, Freund M, van der Heide M, Visser G, Schobben A, de Jong-van den Berg L, Egberts A. Association between antidepressant drug use during pregnancy and child healthcare utilisation. BJOG 2009; DOI: 10.1111/j.1471-0528.2009.02292.x.
ABSTRACT
Objective To evaluate healthcare utilisation by children who were exposed to antidepressant drug use during pregnancy and those whose mothers stopped using antidepressants before pregnancy compared with a control group.

Design Cohort study.

Setting Health insurance records in the Netherlands.

Population A total of 38 602 children born between 2000 and 2005.

Methods Survey of child healthcare utilisation in relation to gestational antidepressant use.

Main outcome measure Healthcare utilisation rates during the first year of life, with special emphasis to medical care related to cardiac disease.

Results Children of mothers who used antidepressants during pregnancy showed increased healthcare use during the first year of life, independent of the mother's healthcare use. The relative risk of more than two visits to general practitioners was 1.5 (95% confidence interval, CI: 1.3–1.8) in the continuous antidepressant users group and 1.3 (95% CI: 1.2–1.5) in the group of children whose mothers stopped taking medication. In both study groups there was a trend towards more drug use for infections and inflammation compared with the control group. Children continuously exposed to antidepressants had an increased risk of cardiac interventions such as cardiovascular surgery or heart catheterisation, relative risk of 5.6 (95% CI: 1.8–17.4). The risk of physiotherapy was twice as high in the antidepressant group compared with the control group (relative risk 2.0; 95% CI: 1.5–2.6).

Conclusion Antidepressant use during pregnancy is associated with increased child healthcare utilisation and increased risk of major cardiac interventions in early childhood.
fuente: Pharmalot today

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Accepted 9 June 2009. Published Online 14 August 2009.

DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1471-0528.2009.02292.x About DOI

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Association between antidepressant drug use during pregnancy and child healthcare utilisation - - BJOG: An International Journal of Obstetrics & Gynaecology