Depression Drug Treatment Outcomes in Pregnancy and the Postpartum Period: A Systematic Review and Meta-analysis

@article{McDonagh2014DepressionDT,
  title={Depression Drug Treatment Outcomes in Pregnancy and the Postpartum Period: A Systematic Review and Meta-analysis},
  author={Marian S. McDonagh and Annette M. Matthews and Carrie Phillipi and Jillian Romm and K. Peterson and Sujata Thakurta and Jeanne-Marie Guise},
  journal={Obstetrics \& Gynecology},
  year={2014},
  volume={124},
  pages={526–534}
}
OBJECTIVE: To evaluate the comparative benefits and harms in both mother and child of antidepressant treatment for depression in pregnant or postpartum women. DATA SOURCES: MEDLINE, the Cochrane Library, CINAHL, Scopus, ClinicalTrials.gov (inception to July 2013), manufacturers, and reference lists. METHODS OF STUDY SELECTION: Two reviewers independently selected studies of pregnant women with depression comparing antidepressants with each other, placebo or no treatment, or nondrug treatments… Expand
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Although statistically significant associations between antidepressant exposure and pregnancy and delivery outcomes were identified, group differences were small and scores in the exposed group were typically within the normal ranges, indicating the importance of considering clinical significance. Expand
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Maternal depression during pregnancy is associated with increased odds for premature delivery and decreased breastfeeding initiation; however, the effects are modest. Expand
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This study prospectively followed women over the course of pregnancy to assess the impact of depression and/or antidepressant treatment on obstetrical outcome and did not demonstrate an adverse effect of fluoxetine exposure per se. Expand
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This study does not suggest a strongly increased risk of malformations, preterm birth, or low birth weight following prenatal exposure to antidepressants after adjustments for level of maternal depression and various sociodemographic and lifestyle factors. Expand
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It is suggested that women who use antidepressants during pregnancy, especially SNRIs and TCAs, have an elevated risk of preeclampsia, which may reflect drug effects or more severe depression. Expand
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Infants exposed to either SSRIs or depression continuously across gestation were more likely to be born preterm than infants with partial or no exposure and neither SSRI nor depression exposure increased risk for minor physical anomalies or reduced maternal weight gain. Expand
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Symptom reduction and improvement in functioning in women with postpartum major depression treated with a tricyclic antidepressant versus a serotonin reuptake inhibitor were compared and Psychosocial functioning improved similarly in both drug-treated groups of mothers. Expand
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Antidepressant use in pregnancy is well studied, but available research has not yet adequately controlled for other factors that may influence birth outcomes including maternal illness or problematic health behaviors that can adversely affect pregnancy. Expand
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