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Does preterm birth increase the initiation of antidepressant use during the postpartum? A population-based

Giovanna Esposito1, Anna Cantarutti2,3, Angela Lupattelli4

  • 1Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.

Frontiers in Pharmacology
|April 11, 2024
PubMed

Insights

Women who deliver preterm babies face a higher risk of starting antidepressant use within a year postpartum. This increased risk is significant for all preterm births, especially extremely preterm deliveries.

Area of Science:

  • Perinatal mental health research
  • Reproductive health epidemiology
  • Psychiatric pharmacovigilance

Background:

  • Preterm birth is a significant obstetric complication with potential long-term impacts on maternal well-being.
  • Maternal mental health, particularly postpartum, is a critical area of concern following childbirth.
  • The association between preterm birth and the initiation of antidepressant use requires further investigation.

Purpose of the Study:

  • To investigate the relationship between preterm birth and the subsequent risk of initiating antidepressant use.
  • To quantify the risk of antidepressant initiation in mothers experiencing preterm births.
  • To explore how the timing of preterm birth influences the risk of postpartum antidepressant use.

Main Methods:

  • A population-based study utilizing regional healthcare utilization databases.
  • Inclusion of over 727,000 deliveries between 2010 and 2020 in Lombardy, Northern Italy.
  • Log-binomial regression analysis to estimate relative risks (RR) and 95% confidence intervals (CI), adjusting for key maternal and delivery factors.

Main Results:

  • Preterm birth was associated with a 38% increased risk of initiating antidepressant use (aRR=1.38) for moderate to late preterm births.
  • Extremely and very preterm births showed an 83% increased risk of antidepressant initiation (aRR=1.83).
  • These associations remained consistent after excluding women with single prescriptions or those using other psychotropic drugs.

Conclusions:

  • Women with preterm deliveries exhibit an elevated risk of initiating antidepressant use in the first year postpartum.
  • The findings highlight a critical need for enhanced mental health support for mothers of preterm infants.
  • This study underscores the importance of considering preterm birth as a risk factor for postpartum depression and anxiety requiring pharmacological intervention.
Abstract

Keywords:
antidepressantdepressionmaternal mental healthpostpartumpreterm

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