Risk of preterm delivery and other adverse perinatal outcomes in relation to maternal use of psychotropic medications during pregnancy

Volume 201, Issue 6, Pages 579.e1-579.e8 (December 2009)
Risk of preterm delivery and other adverse perinatal outcomes in relation to maternal use of psychotropic medications during pregnancy

Ronit Calderon-Margalit, MD, MPHab, Chunfang Qiu, MD, MSd, Asher Ornoy, MDe, David S. Siscovick, MD, MPHabc, Michelle A. Williams, ScDbd
Received 8 December 2008; received in revised form 13 April 2009; accepted 24 June 2009. published online 19 August 2009.

Objective

The purpose of this study was to determine the association of maternal psychotropic medication use during pregnancy with preterm delivery and other adverse perinatal outcomes.

Study Design

A cohort of 2793 pregnant women in Washington State was interviewed, and their medical files were abstracted. Logistic regression models were constructed to assess odds ratios for perinatal outcomes by use of psychotropic medications.

Results

Maternal use of benzodiazepine during pregnancy was associated with an increased risk of preterm delivery (adjusted odds ratio, 6.79; 95% confidence interval, 4.01–11.5) and with increased risks of low birthweight, low Apgar score, neonatal intensive care unit admissions, and respiratory distress syndrome. Selective serotonin receptor inhibitors were associated with preterm deliveries only among women who started treatment after the first trimester.

Conclusion

Benzodiazepine was associated highly with preterm delivery and other adverse perinatal outcomes. Well-conducted cohort studies are warranted to draw conclusions about risks and benefits of psychotropic medication use during pregnancy.

Key words: benzodiazepine, cohort, pregnancy, preterm birth, selective serotonin reuptake inhibitor (SSRI)

a Cardiovascular Health Research Unit, University of Washington School of Public Health and Community Medicine, Seattle, WA

b Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, WA

c Department of Medicine, University of Washington, Seattle, WA

d Center for Perinatal Studies, Swedish Medical Center, Seattle, WA

e Israeli Teratogen Information Service, Laboratory of Teratology, Hebrew University, Hadassah Medical School and Israeli Ministry of Health, Jerusalem, Israel

Reprints: Ronit Calderon-Margalit, MD, University of Washington, Cardiovascular Health Research Unit, 1730 Minor Ave., Suite 1360, Seattle, WA 98101

This research was supported by awards from the National Institutes of Health (R01 HD-32562) and the Swedish Medical Center Foundation.

Cite this article as: Calderon-Margalit R, Qiu C, Ornoy A, et al. Risk of preterm delivery and other adverse perinatal outcomes in relation to maternal use of psychotropic medications during pregnancy. Am J Obstet Gynecol 2009;201:579.e1-8.

PII: S0002-9378(09)00705-4

doi:10.1016/j.ajog.2009.06.061
© 2009 Mosby, Inc. All rights reserved.

abrir aquí:
http://www.ajog.org/article/S0002-9378(09)00705-4/abstract
source: Pharmalot