ResearchObstetricsIncreasing use of antidepressants in pregnancy
Section snippets
Materials and Methods
The study was conducted using data from TennCare, Tennessee’s expanded Medicaid program, for which computerized records of filled prescriptions have been shown to be an accurate source of medication data and have high concordance with patient self-report of medication use.9, 10, 11 Links to vital records (birth, death, and fetal death certificates) files and medical records permit identification of pregnant women, including estimated conception dates.9, 12, 13, 14
Vital records and TennCare
Results
During the study period, the number of mothers who qualified for the cohort each year ranged from 19,421 to 21,997. The mean age (range of mean age 23.2 ± 5.3 years to 23.3 ± 5.2 years) and proportions of mothers who were prima gravida (proportion for each year ranged from 24.3-25.5%), were black race (28.2-40.5%), had greater than 12 years of education (14.1-15.1%), resided in an urban county (43.0-45.5%), and who resided in neighbors with the lowest income (23.6-26.8%) did not change
Comment
In this study of antidepressant use during pregnancy in a large cohort of women enrolled in the TennCare program, we found a marked temporal trend of increasing use during the 5-year period 1999 through 2003. By 2003, more than 13% of pregnancies had an antidepressant exposure. SSRIs accounted for most of the increase in antidepressant exposures, with use of these drugs by more than 10% of pregnant women by 2003. Use of other antidepressants during pregnancy increased at a more moderate rate
Acknowledgments
We gratefully acknowledge the Tennessee Department of Health and the TennCare Bureau, who provided the data for the study.
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Cite this article as: Cooper WO, Willy ME, Pont SJ, et al. Increasing use of antidepressants in pregnancy. Am J Obstet Gynecol 2007;196;544.e1-544.e5.
Funding to conduct the study was provided by the Food and Drug Administration (contract #HHSF223200510010C) and the Centers for Education and Research on Therapeutics, Agency for Healthcare Research and Quality (HS-0384).