title: Risk of gestational hypertension and preeclampsia in women who discontinued or continued antidepressant medication use during pregnancy.
abstract: This study aimed to examine the association between discontinued and continued use of antidepressants and risk for gestational hypertension (GH) and preeclampsia (PE).
  
  
  
  Data from the MotherToBaby pregnancy studies from 2004 to 2014 were analyzed to compare women who discontinued antidepressant use ˂20 weeks of gestation (discontinuers) and women who continued antidepressant use ≥20 weeks of gestation (continuers) to non-users for risk of GH (blood pressure ≥140/90 mmHg on two or more occasions at ≥20 weeks of gestation) and PE (GH with proteinuria). Maternal data, including exposures and study outcomes, were collected through multiple phone interviews. Medical records were used to validate outcomes. Odds ratios (ORs) and 95 % confidence intervals were estimated using logistic regression. Risk for GH and PE were also assessed within antidepressant drug classes.
  
  
  
  Data from 3471 women were analyzed. Continuers were significantly at risk for GH (adjusted odds ratios (aOR) 1.83; 95 % CI 1.05, 3.21) after adjustment. Analyses by drug class showed that continued use of serotonin-norepinephrine reuptake inhibitors (SNRI) increased risk for GH; however, of the 21 women who continued to use SNRI, only 3 developed GH. Continuers who used two or more antidepressant drug classes had increased risk for PE. Selective serotonin reuptake inhibitors or other antidepressant use was not associated with increased risk for GH or PE. No significant associations with PE or GH were found for discontinuers.
  
  
  
  Results suggest that women who continued to use antidepressants in the second half of pregnancy are at risk for GH and PE. No significant association was found among discontinuers.
authors: University of California, La Jolla, San Diego, California, USA. mdeocampo@ucsd.edu.|San Diego State University, San Diego, California, USA. mdeocampo@ucsd.edu.|Department of Family Medicine and Public Health, University of California, 9500 GilmanDrive, La Jolla, San Diego, CA, 92093-0725, USA. mdeocampo@ucsd.edu.
authors: Maria P G
authors: MPG
authors: De Ocampo
authors: University of California, La Jolla, San Diego, California, USA.|Department of Family Medicine and Public Health, University of California, 9500 GilmanDrive, La Jolla, San Diego, CA, 92093-0725, USA.
authors: Maria Rosario G
authors: MRG
authors: Araneta
authors: San Diego State University, San Diego, California, USA.
authors: Caroline A
authors: CA
authors: Macera
authors: San Diego State University, San Diego, California, USA.
authors: John E
authors: JE
authors: Alcaraz
authors: University of California, La Jolla, San Diego, California, USA.
authors: Thomas R
authors: TR
authors: Moore
authors: University of California, La Jolla, San Diego, California, USA.|Department of Family Medicine and Public Health, University of California, 9500 GilmanDrive, La Jolla, San Diego, CA, 92093-0725, USA.
authors: Christina D
authors: CD
authors: Chambers
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000145:classification / Q000627:therapeutic use; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D005865:Gestational Age; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D007407:Interviews as Topic / Q000379:methods; D008499:Medical Records / Q000706:statistics & numerical data; D054539:Medication Therapy Management / Q000706:statistics & numerical data; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D011247:Pregnancy; D018570:Risk Assessment; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D013223:Statistics as Topic; D014481:United States
chemical_list: D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors
keywords: Antidepressants; Gestational hypertension; Preeclampsia