Increasing use of antidepressants in pregnancy

Objective: The purpose of this study was to quantify the rate of exposures to antidepressants during pregnancy in a large cohort of women. Study Design: This was a retrospective cohort study of 105,335 pregnancies among women enrolled in Tennessee Medicaid from 1999-2003. Pregnancies were classified according to antidepressant exposures during pregnancy using previously validated computerized pharmacy records linked with birth certificates. Results: During the study period, 8.7% of women giving birth had exposure to any antidepressant; 6.2% had exposure to a selective serotonin reuptake inhibitor. Maternal age > 25 years (P < .0001), white race (P < .0001), and education > 12 years (P = .008) were significant predictors of antidepressant exposure. The proportion of pregnancies with antidepressant use increased from 5.7% of pregnancies in 1999 to 13.4% of pregnancies in 2003 (p<.0001). The increase was mostly accounted for by increases in selective serotonin reuptake inhibitor exposures. Conclusion: There is an urgent need for further studies that better quantify the fetal consequences of exposure to antidepressants.