期刊
GENERAL HOSPITAL PSYCHIATRY
卷 35, 期 3, 页码 265-271出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.genhosppsych.2012.12.010
关键词
Antidepressants; Medicaid; National cohort; Patterns of medication use; Pregnancy
类别
资金
- Agency for Healthcare Research and Quality Award [R01 HSO18533]
- National Institute of Child Health and Human Development, National Institutes of Health [T32HD060454]
Objective: The risk of depression in women is greatest at childbearing age. We sought to examine and explain national trends in antidepressant use in pregnant women. Methods: This was a cohort study including pregnant women aged 12-55 who were enrolled in Medicaid during 2000-2007. We examined the proportion of women taking antidepressants during pregnancy by patient characteristics (descriptive), by region (mixed-effects model) and over time (interrupted time series). Results: We identified 1,106,757 pregnancies in 47 states; mean age was 23 years, and 60% were nonwhite. Nearly 1 in 12 used an antidepressant during pregnancy. Use was higher for older (11.2% for age >= 30 vs. 7.6% for <30) and white (14.4% vs. 4.0% for nonwhite) women. There was a four-to fivefold difference in rate of antidepressant use among states. Of the 5.3% of women taking antidepressants at conception, 33% and 17% were still on treatment 90 and 180 days, respectively, into pregnancy; an additional 4% began use during pregnancy. Labeled pregnancy-related health advisories did not appear to affect antidepressant use. Conclusions: Antidepressant use during pregnancy remains high in this population; treatment patterns vary substantially by patient characteristics and region. Comparative safety and effectiveness data to help inform treatment choices are needed in this setting. (C) 2013 Elsevier Inc. All rights reserved.
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