title: Perinatal outcomes of pregnancies complicated by maternal depression with or without selective serotonin reuptake inhibitor therapy.
abstract: BACKGROUND
  Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed psychotropics for major depressive disorder during pregnancy and are used in up to 6.2% of pregnancies.
  
  
  OBJECTIVE
  To compare the perinatal outcomes of pregnancies complicated by maternal depression with or without SSRI therapy versus nondepressed pregnancies.
  
  
  METHODS
  International Classification of Diseases (ICD)-9 codes for depression were identified among women who delivered at the University of Iowa from April 2009 to March 2011. Data were extracted from linked maternal-neonatal records for all charts with an ICD-9 code for depression and an equal number of women without ICD-9 codes for depression.
  
  
  RESULTS
  Of the 3,695 women who delivered between 2009 and 2011, 238 had an ICD-9 code for depression. Sixteen women had depression listed in their records but did not have an ICD-9 code for depression. Their data were combined with those of the women with ICD-9 codes for depression, and it was found that 126 women (50%) in this combined depression cohort received an SSRI. Women with depression had increased alcohol and tobacco use, BMI and premature delivery rates (p < 0.01). Maternal depression was associated with an increased frequency of neonatal intensive care unit (NICU) admission (p < 0.001). In addition to depression, maternal SSRI use, obesity and smoking were univariate predictors of NICU admission.
  
  
  CONCLUSIONS
  Among women with depression, the use of an SSRI was not associated with significant differences in any of the measured maternal or neonatal parameters, but further studies are needed to evaluate the specific effects of SSRI exposure in early or late gestation. Despite SSRI utilization, women with depression continue to have increased risks during pregnancy.
authors.affiliation: Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
authors.forename: Holly J
authors.initials: HJ
authors.lastname: Engelstad
authors.forename: Robert D
authors.initials: RD
authors.lastname: Roghair
authors.forename: Chadi A
authors.initials: CA
authors.lastname: Calarge
authors.forename: Tarah T
authors.initials: TT
authors.lastname: Colaizy
authors.forename: Scott
authors.initials: S
authors.lastname: Stuart
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Haskell
mesh_terms: D000328:Adult; D003866:Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis / Q000453:epidemiology; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced / Q000453:epidemiology; D011379:Prognosis; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D012720:Severity of Illness Index
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors