Psychiatric visits during the postpartum year in women with eating disorders who continue or discontinue antidepressant treatment in pregnancy.
antidepressant
eating disorders
postpartum
pregnancy
preventative effect
Journal
The International journal of eating disorders
ISSN: 1098-108X
Titre abrégé: Int J Eat Disord
Pays: United States
ID NLM: 8111226
Informations de publication
Date de publication:
03 2023
03 2023
Historique:
revised:
23
11
2022
received:
20
06
2022
accepted:
06
12
2022
pubmed:
17
12
2022
medline:
3
3
2023
entrez:
16
12
2022
Statut:
ppublish
Résumé
To determine the association between continued antidepressant use in pregnancy and postpartum psychiatric visits for eating (ED) or mood/anxiety disorders in women with preexisting ED. Using Danish health registry data (1998-2015), we identified 3529 pregnancies in women with ED prepregnancy: (i) 564 with continued antidepressant use before and during pregnancy; (ii) 778 with discontinued antidepressants before pregnancy; (iii) 2137 unexposed. Outpatient and inpatient postpartum visits for an ED or a mood/anxiety disorder constituted the outcome measures. We estimated hazard ratios (HRs) and 95% confidence intervals (CI) using Cox regression with inverse probability of treatment weighting, and performed stratified analyses by antidepressant prescription filling in the first 3 months postpartum. The weighted cumulative incidence for an ED visit at end of follow-up was 4.5% (continued) and 4.8% (discontinued). We found no association between continued antidepressant and postpartum ED visit, relative to discontinued (HR: 0.89, 95% CI: 0.52-1.52). The HR for postpartum mood/anxiety disorder visit was 1.27 (95% CI: 0.68-2.36) with continued antidepressants versus discontinued but decreased if more than two antidepressant prescriptions were refilled. Continued antidepressant use was associated with a 57% reduced likelihood of a postpartum ED visit versus discontinued use in pregnancies with antidepressant prescription refills in the early postpartum. Among women with preexisting ED, there was no association between continued antidepressant use during pregnancy and the likelihood of postpartum psychiatric visits, relative to discontinued antidepressants before pregnancy. Continuation of treatment into the early postpartum is associated with reduced likelihood of postpartum ED visit. Based on data from the Danish registries, we identified 3529 pregnancies among women with preexisting eating disorders before pregnancy. Women with continued antidepressant treatment both before and during pregnancy did not have a lower probability of having postpartum psychiatric visits for an eating disorder or for mood/anxiety disorders (often coexisting with eating disorders), relative to those who discontinued antidepressants before pregnancy. Further continuation of antidepressant treatment into the early postpartum is associated with improved maternal postpartum outcomes. However, residual confounding by disease severity limits confidence in this conclusion.
Substances chimiques
Antidepressive Agents
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
582-594Subventions
Organisme : NIMH NIH HHS
ID : R01 MH118278
Pays : United States
Organisme : NIMH NIH HHS
ID : R01 MH119084
Pays : United States
Organisme : NIMH NIH HHS
ID : R01 MH124871
Pays : United States
Organisme : NIMH NIH HHS
ID : R01 MH120170
Pays : United States
Informations de copyright
© 2022 The Authors. International Journal of Eating Disorders published by Wiley Periodicals LLC.
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