Association between antidepressant drug use during pregnancy and child healthcare utilisation.
OBJECTIVE
To evaluate healthcare utilisation by children who were exposed to antidepressant drug use during pregnancy and those whose mothers stopped using antidepressants before pregnancy compared with a control group.


METHODS
Cohort study. Setting Health insurance records in the Netherlands.


METHODS
A total of 38 602 children born between 2000 and 2005.


METHODS
Survey of child healthcare utilisation in relation to gestational antidepressant use.


METHODS
Healthcare utilisation rates during the first year of life, with special emphasis to medical care related to cardiac disease.


RESULTS
Children of mothers who used antidepressants during pregnancy showed increased healthcare use during the first year of life, independent of the mother's healthcare use. The relative risk of more than two visits to general practitioners was 1.5 (95% confidence interval, CI: 1.3-1.8) in the continuous antidepressant users group and 1.3 (95% CI: 1.2-1.5) in the group of children whose mothers stopped taking medication. In both study groups there was a trend towards more drug use for infections and inflammation compared with the control group. Children continuously exposed to antidepressants had an increased risk of cardiac interventions such as cardiovascular surgery or heart catheterisation, relative risk of 5.6 (95% CI: 1.8-17.4). The risk of physiotherapy was twice as high in the antidepressant group compared with the control group (relative risk 2.0; 95% CI: 1.5-2.6).


CONCLUSIONS
Antidepressant use during pregnancy is associated with increased child healthcare utilisation and increased risk of major cardiac interventions in early childhood.
Ververs
T F
TF
Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands.
van Wensen
K
K
Freund
M W
MW
van der Heide
M
M
Visser
G H A
GH
Schobben
A F A M
AF
de Jong-van den Berg
L T W
LT
Egberts
A C G
AC
D000928:Antidepressive Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002662:Child Health Services / Q000706:statistics & numerical data*; D015331:Cohort Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D003866:Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology; D004334:Drug Administration Schedule; D005260:Female; D006330:Heart Defects, Congenital / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008431:Maternal-Fetal Exchange; D009426:Netherlands / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000453:epidemiology; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*
D000928:Antidepressive Agents