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Association between antidepressant drug use during pregnancy and child healthcare utilisation

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Abstract:

Please cite this paper as: Ververs T, van Wensen K, Freund M, van der Heide M, Visser G, Schobben A, de Jong-van den Berg L, Egberts A. Association between antidepressant drug use during pregnancy and child healthcare utilisation. BJOG 2009; DOI: 10.1111/j.1471-0528.2009.02292.x. Objective 

To evaluate healthcare utilisation by children who were exposed to antidepressant drug use during pregnancy and those whose mothers stopped using antidepressants before pregnancy compared with a control group. Design 

Cohort study. Setting 

Health insurance records in the Netherlands. Population 

A total of 38 602 children born between 2000 and 2005. Methods 

Survey of child healthcare utilisation in relation to gestational antidepressant use. Main outcome measure 

Healthcare utilisation rates during the first year of life, with special emphasis to medical care related to cardiac disease. Results 

Children of mothers who used antidepressants during pregnancy showed increased healthcare use during the first year of life, independent of the mother’s healthcare use. The relative risk of more than two visits to general practitioners was 1.5 (95% confidence interval, CI: 1.3–1.8) in the continuous antidepressant users group and 1.3 (95% CI: 1.2–1.5) in the group of children whose mothers stopped taking medication. In both study groups there was a trend towards more drug use for infections and inflammation compared with the control group. Children continuously exposed to antidepressants had an increased risk of cardiac interventions such as cardiovascular surgery or heart catheterisation, relative risk of 5.6 (95% CI: 1.8–17.4). The risk of physiotherapy was twice as high in the antidepressant group compared with the control group (relative risk 2.0; 95% CI: 1.5–2.6). Conclusion 

Antidepressant use during pregnancy is associated with increased child healthcare utilisation and increased risk of major cardiac interventions in early childhood.

Keywords: Antidepressants; cardiac intervention; healthcare utilisation; paediatrics; physiotherapy; pregnancy

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1471-0528.2009.02292.x

Affiliations: 1: VGZ Health Insurance Company, Nijmegen, The Netherlands 2: Department of Pediatric Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands 3: Department of Perinatology and Gynaecology, University Medical Center Utrecht, Utrecht, The Netherlands 4: Department of Pharmacy, Unit Pharmacoepidemiology and Pharmacoeconomics, University of Groningen, Utrecht, The Netherlands

Publication date: November 1, 2009

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