Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/104021
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Type: | Journal article |
Title: | Antidepressant use in late gestation and risk of postpartum haemorrhage: a retrospective cohort study |
Author: | Grzeskowiak, L. McBain, R. Dekker, G. Clifton, V. |
Citation: | BJOG: an International Journal of Obstetrics and Gynaecology, 2016; 123(12):1929-1936 |
Publisher: | Wiley |
Issue Date: | 2016 |
ISSN: | 1470-0328 1471-0528 |
Statement of Responsibility: | LE Grzeskowiak, R McBain, GA Dekker, VL Clifton |
Abstract: | Objective: To investigate the association between antidepressant use in late gestation and postpartum haemorrhage (PPH). Design: Retrospective cohort study. Tertiary teaching hospital in Adelaide, Australia. Population: A total of 30 198 women delivering between 2002 and 2008. Methods: Relative risks adjusted for maternal sociodemographics and comorbidities (aRRs) were calculated for PPH, comparing women with late-gestation exposure to antidepressants (n = 558), women with a psychiatric illness but no antidepressant use (n = 1292), and women with neither antenatal exposures (n = 28 348). Additional sensitivity analyses were undertaken, examining associations with severe PPH and postpartum anaemia. Main Outcome Measures: The primary outcome was PPH, defined as a recorded blood loss of ≥500 mL for vaginal deliveries and ≥1000 mL for caesarean sections. Secondary outcomes included severe PPH (≥1000 mL blood loss, irrespective of method of delivery), and the presence of postpartum anaemia (identified from hospital medical records). Results: Compared with unexposed controls, women exposed to antidepressants had an increased risk of PPH (aRR 1.53; 95% confidence interval, 95% CI 1.25-1.86), whereas no increased risk was observed for women with a psychiatric illness but no antidepressant use (aRR 1.04; 95% CI 0.89-1.23). In sensitivity analyses, late gestation antidepressant exposure was associated with an increased risk of severe PPH (aRR 1.84; 95% CI 1.39-2.44), as well as postpartum anaemia (aRR 1.80; 95% CI 1.46-2.22). Conclusions: Exposure to antidepressants in late gestation was associated with a significantly increased risk of PPH. Although potential confounding by unmeasured factors cannot be ruled out, these findings suggest a direct effect of antidepressant exposure on PPH. |
Keywords: | Antidepressive agents; postpartum haemorrhage; pregnancy; prenatal exposure; selective serotonin reuptake inhibitors |
Rights: | © 2015 Royal College of Obstetricians and Gynaecologists 1929 |
DOI: | 10.1111/1471-0528.13612 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/1041918 http://purl.org/au-research/grants/nhmrc/1070421 |
Published version: | http://dx.doi.org/10.1111/1471-0528.13612 |
Appears in Collections: | Aurora harvest 7 Paediatrics publications |
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hdl_104021.pdf | Accepted Version | 844.99 kB | Adobe PDF | View/Open |
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