Risk of preterm delivery and other adverse perinatal outcomes in relation to maternal use of psychotropic medications during pregnancy
Received 8 December 2008; received in revised form 13 April 2009; accepted 24 June 2009. published online 19 August 2009.
Objective
The purpose of this study was to determine the association of maternal psychotropic medication use during pregnancy with preterm delivery and other adverse perinatal outcomes.
Study Design
A cohort of 2793 pregnant women in Washington State was interviewed, and their medical files were abstracted. Logistic regression models were constructed to assess odds ratios for perinatal outcomes by use of psychotropic medications.
Results
Maternal use of benzodiazepine during pregnancy was associated with an increased risk of preterm delivery (adjusted odds ratio, 6.79; 95% confidence interval, 4.01–11.5) and with increased risks of low birthweight, low Apgar score, neonatal intensive care unit admissions, and respiratory distress syndrome. Selective serotonin receptor inhibitors were associated with preterm deliveries only among women who started treatment after the first trimester.
Conclusion
Benzodiazepine was associated highly with preterm delivery and other adverse perinatal outcomes. Well-conducted cohort studies are warranted to draw conclusions about risks and benefits of psychotropic medication use during pregnancy.
aCardiovascular Health Research Unit, University of Washington School of Public Health and Community Medicine, Seattle, WA
bDepartment of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, WA
cDepartment of Medicine, University of Washington, Seattle, WA
dCenter for Perinatal Studies, Swedish Medical Center, Seattle, WA
eIsraeli Teratogen Information Service, Laboratory of Teratology, Hebrew University, Hadassah Medical School and Israeli Ministry of Health, Jerusalem, Israel
Reprints: Ronit Calderon-Margalit, MD, University of Washington, Cardiovascular Health Research Unit, 1730 Minor Ave., Suite 1360, Seattle, WA 98101
This research was supported by awards from the National Institutes of Health (R01 HD-32562) and the Swedish Medical Center Foundation.
Cite this article as: Calderon-Margalit R, Qiu C, Ornoy A, et al. Risk of preterm delivery and other adverse perinatal outcomes in relation to maternal use of psychotropic medications during pregnancy. Am J Obstet Gynecol 2009;201:579.e1-8.
ABSTRACT