TY - JOUR PY - 2014// TI - Antidepressant treatment of depression during pregnancy and the postpartum period JO - Evidence report technology assessment A1 - McDonagh, Marian A1 - Matthews, Annette A1 - Phillipi, Carrie A1 - Romm, Jillian A1 - Peterson, Kim A1 - Thakurta, Sujata A1 - Guise, Jeanne-Marie SP - 1 EP - 308 VL - ePub IS - 216 N2 - To address gaps in the direct evidence, we included an additional 109 observational studies of pregnant women receiving antidepressants for mixed or unreported reasons compared with pregnant women not taking antidepressants whose depression status was unknown. Signals from this indirect evidence suggest that future research should focus on the comparative risk of congenital anomalies and neonatal motor developmental delays. Although the absolute increased risk of autism spectrum disorder or attention-deficit hyperactivity disorder in the child associated with antidepressant use for depression in pregnancy may be very small, this issue also merits attention in future research. Future research should compare available treatments in groups of women with depression and have adequate sample sizes. Investigations should also take into account potential confounding, including age, race, parity, other exposures (e.g., alcohol, smoking, and other potential teratogens), and the impact of dose, severity of depression, timing of diagnosis, or prior depressive episodes.

CONCLUSIONS: Evidence about the comparative benefits and harms of pharmacological treatment of depression in pregnant and postpartum women was largely inadequate to allow well-informed decisions about treatment. For pregnant women, this was mainly because comparison groups were not exclusively depressed women. For postpartum women, the lack of evidence arose chiefly from a scarcity of studies. These are major limitations, as depression is known to be associated with serious adverse outcomes. Given the prevalence of depression and its impact on the lives of pregnant women, new mothers, and children, new research to fill this informational gap is essential.

This publication is in the public domain.

Language: en

LA - en SN - 1530-4396 UR - http://dx.doi.org/10.23970/AHRQEPCERTA216 ID - ref1 ER -