title: Fertility history and use of antidepressant medication in late mid-life: a register-based analysis of Norwegian women and men.
abstract: Life course influences on later life depression may include parenting trajectories. We investigate associations between number and timing of births and use of antidepressant medication in late mid-life using data on the whole Norwegian population.
  
  
  
  We estimated logistic regression models to analyse variations in the purchase of antidepressants between 2004 and 2008 by timing of births and number of children among women and men aged 45-73, using Norwegian population register data. We controlled for age, education, marital and partnership status, and (in some models) family background shared among siblings.
  
  
  
  Mothers and fathers of two or more children were generally less likely to purchase antidepressants than the childless. Mothers who started childbearing before age 22 were an exception, although according to sibling models they were not more likely to purchase antidepressants. All models showed that women who became mothers before age 26 and had only one child had higher odds of medication purchase than the childless. Older age at first birth was generally associated with lower risks of antidepressant purchase.
  
  
  
  This analysis of high-quality data for a national population indicates that early motherhood, childlessness and low parity are associated with higher usage of antidepressants in late mid-life. Our data did not allow identification of mediating pathways, and we lacked information on early mental and physical health and some other potentially important confounders not shared between siblings. Furthermore purchase of antidepressants is not a perfect indicator of depression. Those concerns aside, the results suggest complex effects of fertility on depression that merit further investigation.
authors.affiliation: a Norwegian Institute of Public Health , Oslo , Norway.|b Department of Economics , University of Oslo , Norway.
authors.forename: Øystein
authors.initials: Ø
authors.lastname: Kravdal
authors.affiliation: c Department of Social Policy , London School of Economics and Political Science , London , United Kingdom.
authors.forename: Emily
authors.initials: E
authors.lastname: Grundy
authors.affiliation: a Norwegian Institute of Public Health , Oslo , Norway.
authors.forename: Vegard
authors.initials: V
authors.lastname: Skirbekk
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003863:Depression / Q000453:epidemiology* / Q000628:therapy; D005191:Family Characteristics; D005220:Fathers / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008423:Maternal Age; D008875:Middle Aged; D009035:Mothers / Q000523:psychology / Q000706:statistics & numerical data*; D009664:Norway / Q000453:epidemiology; D010298:Parity; D011247:Pregnancy; D012042:Registries; D012306:Risk; D035781:Siblings / Q000523:psychology
chemical_list: D000928:Antidepressive Agents
keywords: Antidepressants; Norway; fertility; prescription; register; sibling fixed effects