The prevalence of major depression in women in Europe in a 12- month period has been estimated at 3.0-11.2%. Untreated depression in pregnancy is associated with significant morbidity and unhealthy lifestyle behaviours and increases the risk of poor birth outcomes. Pharmacotherapy with SSRls is a common treatment approach, including in pregnancy, but there are concerns about effects on the fetus, including an increased risk of congenital heart defects (CHDs). The aim of this thesis was to investigate the teratogenic risks of antidepressant use by pregnant women and the socio-demographic characteristics of women of childbearing age who use antidepressants in order to inform clinical practice and public health interventions. A case-malformed control study was performed with data from 12 European Countries in EUROCAT: a European network of population-based congenital anomaly (CA) registries. The results showed that infants/fetuses with CHDs were significantly more likely to have been exposed in the first trimester to SSRls compared to infants/fetuses with CAs other than CHD (Odds Ratio 1.38, 95% Confidence Interval 1.05-1.82). The association was stronger for severe CHD (OR 1.54, 95% CI 1.04-2.28) and, therefore, cannot be explained as a product of neonatal or infant examination bias. Specific associations were demonstrated for Ebstein's anomaly, and Tetralogy of Fallot. Five signals in the literature for anorectal atresia and stenosis, gastroschisis, renal dysplasia, clubfoot, and hypospadias were supported, and a new association detected for microcephaly. In all the observed associations, there was little evidence of specificity as to SSRI type.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:627733 |
| Date | January 2013 |
| Creators | Wemakor, Anthony Kwesi |
| Publisher | University of Ulster |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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