women treated with antidepressants during pregnancy do not show an increased risk of having babies with heart abnormalities congenital. New research shows a significant increase in risk in women with specific characteristics often associated with the use of antidepressants.
dr. Irene Peterson, of the Università of the Department of Primary Care and Population, in England, says: “The women who received a prescription of SSRIs (selective inhibitors of serotonin reuptake) in pregnancy have an increased risk of having a child with abnormalities, congenital heart compared to the other women, così as those who have taken antidepressants-SSRIS”. “The results persist after the evaluation of the data, sociodemographic, life-style, and taking other psychotropic drugs”.
In previous research, which had examined the risk of cardiac malformations in children born to mothers who were taking antidepressant drugs, the results were contradictory. The authors, forò underline that these studies were not considered to be a amounts and categories of risk factors that can be associated with the use of antidepressants or depression itself.
“it is surprising that many published studies do not take into account risk factors that are common and important, he explained, the Petersen – often the database used during the study do not contain information on diabetes, alcohol intake, obesityà and the use of drugs.”
The study, published in January 2015 in the Journal of Psychiatry, included 5154 women treated with SSRIs before pregnancy, 2776, treated during pregnancy and 993 that had been treated with other types of antidepressants. These groups were compared with 200.231 women who had not received treatment with antidepressant drugs before or during pregnancy.
Overall, in all the groups considered were found less than 1% of congenital heart disease in the first 5 years of life of children. There were no significant differences after having adjusted the data for the state sociodemografico, life style, and the use of other psychotropic drugs.
Were associated, however, with the heart malformations, other risk factors, such as the diabetes, età advanced, the use of alcohol, taking drugs, and a body mass index greater than 30.
The presence of these risk factors was significantly più high in women who were taking or had taken anti-depressants, SSRIs or no, before and during pregnancy.
About a third of the women who had been treated with antidepressants before or during pregnancy were smokers, compared with 19% of those who had not been therapies of this type; from 8% to 10% were obese compared to the 3.5/4 .8%, from 3.5% to 4.8% had diabetes, compared with 2.6%;from 1.8% to 6.5% took drugs, and from 1.6% to 4.1% took alcohol as compared to the 0.4% for both conditions, women are not treated.
The authors state that “although the absolute number of women who had problems with alcohol and drugs was small, it was still 16 times higher in women who continued to use antidepressants during pregnancy.
È was also found that in women who had been treated with antidepressant non-SSRI, the rate of delivery before 37 week (15%) was double compared to women who had not received any treatment.
The rate of preterm delivery of women who were taking SSRIS was from 8.6% to 10.7 inhibitors of The reuptake of serotonin, more common are fluoxetine, citalopram, paroxetine, sertraline, and escitalopram and the più common non-SSRIS are venlafaxine, the amitriptylina,dosulepin, lofepramina, and clomipramine.
Other research has shown that the risk of congenital malformations would be più high in the case of the use of paroxetine, and that the role of the serotonin may be important during the development of the fetal heart in the first quarter.
The authors suggest, in short, to consider case by case the use of antidepressant drugs in pregnancy, as depression itself is a risk factor for the mother and the fetus.
dr. Peterson suggests that for some women pregnancy may be the right time to stop treatment, but that this is not affecting all women suffering from depression.
“You also have to remember that the proportion of women with diabetes, with a history of abuse of drugs or alcohol, are more often treated with antidepressant medications and these are as già mentioned, risk factors for congenital heart defects independent of the assumption or not of drugs. On the other hand, it is also important to consider the negative impact of the depressine not treated on the health and well-being of the mother and child”.
Fonte: J Clin Psychiatry
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