title: Antidepressant use during pregnancy and risk of postpartum hemorrhage: A systematic review and meta-analysis.
abstract: Evidence about relationship between antidepressant use during pregnancy and the risk of postpartum hemorrhage (PPH) is conflicting. The aim of this meta-analysis was to systematically assess this relationship. To identify relevant studies, we conducted systematic searches in PubMed and Embase of articles published through May 2016. Random-effects models were adopted to estimate overall relative risk. In total, eight studies involving more than 40,000 PPH cases were included in our meta-analysis. After pooling the estimates, the odds for developing PPH were 1.32-fold higher (risk ratio, RR = 1.32; 95% confidence interval, CI = 1.17-1.48) in antidepressant users compared with individuals who had not taken antidepressants. In subgroup analyses, the associations still exist for women with exposure to non-SRI (RR = 1.31, 95% CI = 1.1-1.56), SRIs (RR = 1.23, 95% CI = 1.06-1.44), SSRIs (RR = 1.2, 95% CI = 1.04-1.38), and SNRIs (RR = 1.62, 95% CI = 1.41-1.85). Based on exposure window, we found an increased risk of PPH among current (RR = 1.37, 95% CI = 1.09-1.71) and recent users (RR = 1.32, 95% CI = 1.15-1.51), but not past users (RR = 1.08, 95% CI = 0.88-1.31). The findings of this meta-analysis support an increased risk of PPH in women exposure to antidepressant during late gestation.
authors.affiliation: State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China.
authors.forename: Hai-Yin
authors.initials: HY
authors.lastname: Jiang
authors.affiliation: Department of Psychiatry, Hangzhou Seventh People's Hospital, Hangzhou, 310013, China.
authors.forename: Lian-Lian
authors.initials: LL
authors.lastname: Xu
authors.affiliation: State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China.
authors.forename: Yu-Cuan
authors.initials: YC
authors.lastname: Li
authors.affiliation: State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China.
authors.forename: Min
authors.initials: M
authors.lastname: Deng
authors.affiliation: State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China.
authors.forename: Chun-Ting
authors.initials: CT
authors.lastname: Peng
authors.affiliation: State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China. Electronic address: hzruanbing@gmail.com.
authors.forename: Bing
authors.initials: B
authors.lastname: Ruan
mesh_terms: D000928:Antidepressive Agents / Q000009:adverse effects*; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D006473:Postpartum Hemorrhage / Q000139:chemically induced* / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced* / Q000453:epidemiology; D012306:Risk
chemical_list: D000928:Antidepressive Agents
keywords: 5HT; Bleed; Depression; Meta-analysis; Pregnant