title: Prevalence and patterns of antidepressant drug use during pregnancy.
abstract: OBJECTIVE
  The aim of this study was to determine the extent and patterns of antidepressant use before, during and after pregnancy in a large population in The Netherlands.
  
  
  METHODS
  Health care records and prescription data from one of the largest Dutch health insurance companies were analysed. The study cohort consisted of 29,005 women who had live births in the period between January 2000 and July 2003. Antidepressant drug use during a specified period was defined as there being a record of a prescription during that period.
  
  
  RESULTS
  During the first trimester of pregnancy 2% of all pregnant women of the study cohort were found to have taken antidepressants; in the second and third trimesters, this figure had dropped to 1.8% of all pregnancies. Antidepressant use before as well as during pregnancy was almost twofold higher in women over 35 years of age than in those under 35 years. Almost 60% of the women who used antidepressants before pregnancy stopped taking them in the first trimester, and a smaller number stopped thereafter. Of all women using antidepressants during pregnancy, one third started this medication during gestation. In the 3 months following delivery, the prevalence of antidepressant use was the same as before pregnancy (2.9%). There was no shift to benzodiazepines in the group of women who stopped taking antidepressants during pregnancy. Although paroxetine and fluoxetine were the most frequently used antidepressants among the study group, all modern antidepressants were used.
  
  
  CONCLUSIONS
  A considerable number of women are being exposed to antidepressants throughout pregnancy up until delivery. One consequence of this is that their newborns need special care and supervision during the first days of life. However, women who stop taking the medication may risk a relapse of their illness, and this may also have a negative effect on the child.
authors.affiliation: Department of Clinical Pharmacy, Clinical Chemistry and Laboratory Medicine, University Medical Center (UMC) Utrecht, Utrecht, The Netherlands.
authors.forename: Tessa
authors.initials: T
authors.lastname: Ververs
authors.forename: Hans
authors.initials: H
authors.lastname: Kaasenbrood
authors.forename: Gerard
authors.initials: G
authors.lastname: Visser
authors.forename: Fred
authors.initials: F
authors.lastname: Schobben
authors.forename: Lolkje
authors.initials: L
authors.lastname: de Jong-van den Berg
authors.forename: Toine
authors.initials: T
authors.lastname: Egberts
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use; D016208:Databases, Factual / Q000706:statistics & numerical data; D003866:Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology; D011307:Drug Prescriptions / Q000145:classification / Q000706:statistics & numerical data; D004359:Drug Therapy, Combination; D017723:Drug Utilization Review / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use; D006801:Humans; D007356:Insurance, Pharmaceutical Services / Q000706:statistics & numerical data; D009426:Netherlands / Q000453:epidemiology; D017374:Paroxetine / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000453:epidemiology; D011264:Pregnancy Trimesters; D015995:Prevalence; D013997:Time Factors
chemical_list: D000928:Antidepressive Agents; D005473:Fluoxetine; D001569:Benzodiazepines; D017374:Paroxetine