Risk of adverse perinatal outcomes among women with pharmacologically treated and untreated depression during pregnancy: A retrospective cohort study
Bibliographic record
Abstract
BACKGROUND: The association between antidepressant use during pregnancy and adverse perinatal outcomes is unclear. The association without taking into consideration the independent effect of depression leads to a confounding of the effects of antidepressants with those of the underlying reason for the use of those medications. Additionally, a history of depression and antidepressant use may also influence this association. OBJECTIVE: This study examined the risks of adverse perinatal outcomes associated with antidepressant use during pregnancy. METHODS: This retrospective cohort study used population-based data in Alberta, Canada, for women who delivered between 2012 and 2015 (n = 158486). Women with depression were identified using a validated case definition, and the receipt of antidepressants was identified using Anatomical Therapeutic Chemical codes. Adverse perinatal outcomes such as severe maternal/neonatal morbidity, preterm birth, and neonatal intensive care unit admission were assessed. Multivariable log-binomial regression was used to estimate the risk of adverse perinatal outcomes associated with antidepressants, adjusting for age and parity. RESULTS: In total, 9.1% women had depression and 2.5% women received antidepressants during pregnancy. The relative risk of severe neonatal morbidity/mortality was 1.25 (95% confidence interval 1.17, 1.33) times higher for women with depression alone compared to women without depression. The risk of severe neonatal morbidity/mortality was 1.51 (95% confidence interval 1.36, 1.66) times higher for women who used antidepressants compared to women with depression alone-however, the risk differed between the women with and without a history of antidepressant use. A similar risk pattern was observed for preterm birth and neonatal intensive care unit admission. CONCLUSIONS: Both depression and antidepressant use were independently associated with the risk of adverse perinatal outcomes; however, the risk associated with antidepressants was higher over and above the risk associated with depression. This may reflect the biological effects of antidepressants, greater severity of depression in those treated, or both.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".