DEPRESSION AND ANTIDEPRESSANT USE IN PREGNANCY AND ADVERSE MATERNAL AND FETAL/CHILDREN OUTCOMES: A SYSTEMATIC REVIEW AND META-ANALYSIS
Notice bibliographique
Résumé
Abstract Background Antidepressant use during pregnancy has been increasing in the last few decades. Many evidences have indicated the high risks of adverse health outcomes for both pregnant women and their offspring. Aims & Objectives The association may be biased by uncontrolled confounding of maternity depression or mental health status. We performed a systematic review and meta-analysis to generate precise estimates of the association between depression, antidepressants, and reproductive outcomes. Methods The PubMed and Embase were searched from database inception to Sep 23, 2022, for longitudinal cohort studies of pregnant women with exposure to antidepressants or depression, we assessed the risk of adverse maternal and children outcomes. The Newcastle-Ottawa Scale was used for assessing the methodological quality of included studies. Pooled estimates of risk ratio (RR) were conducted by random effects or fixed effects model by comparing adverse pregnant outcomes in women who took antidepressants versus those who did not, or in women with or without a depressive disorder. Further investigations were conducted to compare the effects of depression (pregnant women with untreated depression compared with control women without depression) and antidepressant use (only in women with depression) on 19 adverse pregnancy outcomes including six maternal and fetal outcomes during eight newborn and five childhood or adolescent period. And association were examined in subgroups stratified by different study designs and income levels. Results A total of 134 studies with 40,864,148 participants were included. Compared with pregnant women who did not take antidepressants, those who were exposed had a higher risk for the 16 majority of the focused adverse outcomes in our study, such as abortion (RR,1.33; 95%CI, 1.18-1.49), gestational diabetes (1.24, 1.13- 1.35), 5-minute Apgar score <7 (RR,2.07; 95%CI, 1.95-2.20), ASD (1.69, 1.58-1.80), ADHD (1.30, 1.15- 1.48), depression (2.61, 1.59-4.28), and anxiety (1.74, 1.16-2.61) etc. Compared with women without depression disorder, depressed pregnancy was also associated with increased risks of 8 adverse outcomes, such as low birth weight (LBW) (1.74, 1.24-2.43), preterm birth (1.53, 1.30-1.80), abortion (1.52, 1.45-1.60),. However, when comparing women exposed to antidepressants with those not exposed in the participants of depressed pregnancy, the risks of 2 adverse outcome including preterm birth (1.14, 1.12-1.17) and admission to NICU (1.44,1.33-1.56) were found to be significantly increased. Discussion & Conclusion The adverse outcome of antidepressant use manly come from perinatal depression, which was associated with adverse reproductive outcomes, but antidepressants use in depressed pregnancy did not cause more adverse events except for preterm birth and admission to NICU. Higher risks of most adverse outcomes of antidepressants are mainly associated by the onset of depression itself. More attention should be paid to depression, and health professionals should estimate the risk of depression and antidepressant comprehensively during counseling and prenatal health care.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,009 | 0,025 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,017 | 0,032 |
| Bibliométrie | 0,006 | 0,007 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,001 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».