{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:39:00Z","timestamp":1786977540995,"version":"build-2736575974"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T00:00:00Z","timestamp":1665014400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["the Obstetrical\u2010Fetal Pharmacology Center grants: 1U54HD085601\u201001"],"award-info":[{"award-number":["the Obstetrical\u2010Fetal Pharmacology Center grants: 1U54HD085601\u201001"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["U54HD047891"],"award-info":[{"award-number":["U54HD047891"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["U54HD047905"],"award-info":[{"award-number":["U54HD047905"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008250","name":"Feinberg School of Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008250","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR001422"],"award-info":[{"award-number":["UL1TR001422"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008250","name":"Feinberg School of Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008250","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Pharma and Therapeutics"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:p>\n                    Major depressive disorder (MDD) is a common disorder in pregnancy. Although sertraline is the most frequently prescribed antidepressant for pregnant people in the United States, limited information about its pharmacokinetics in pregnancy is available. Our objectives were to characterize plasma sertraline concentration to dose (C\/D) ratios across pregnancy and postpartum and investigate the effect of pharmacogenetic variability on sertraline elimination. We performed a prospective observational cohort study in people with a singleton pregnancy \u2264\u200918\u2009weeks gestation and a lifetime diagnosis of MDD at the 3 Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)\u2010funded Obstetrical\u2010Fetal Pharmacology Research Center sites. Subjects (\n                    <jats:italic>N<\/jats:italic>\n                    \u00a0=\u00a047) were receiving maintenance sertraline therapy and chose to continue it during pregnancy. Blood samples were obtained 24\u2010hours postdose every 4\u2009weeks across pregnancy and twice postpartum for measurement of plasma concentrations of sertraline and desmethylsertraline. Overall mean sertraline C\/D ratios were decreased at study onset and remained consistently low until after delivery. During the last 4\u2009weeks of pregnancy the mean sertraline C\/D ratio (95% confidence interval (CI)), 0.25 (95% CI, 0.19, 0.3) ng\/mL\/dose (mg\/day), was smaller than the mean ratio at \u2265\u20098\u2009weeks after delivery, 0.32 (95% CI, 0.27, 0.37) ng\/mL\/dose (mg\/day), a 22% difference. Mean sertraline\/desmethylsertraline ratios were highest after birth, which confirmed increased sertraline elimination during pregnancy. Sertraline C\/D ratios in participants with functional CYP2C19 activity did not change significantly during pregnancy, whereas ratios in participants with poor or intermediate CYP2C19 activity decreased by 51%. Exploratory pharmacogenomic analysis indicated that pregnant people with poor or intermediate CYP2C19 activity are at risk for subtherapeutic sertraline concentrations during pregnancy.\n                  <\/jats:p>","DOI":"10.1002\/cpt.2746","type":"journal-article","created":{"date-parts":[[2022,9,12]],"date-time":"2022-09-12T07:43:16Z","timestamp":1662968596000},"page":"1280-1290","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Changes in Sertraline Plasma Concentrations Across Pregnancy and Postpartum"],"prefix":"10.1111","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7186-1877","authenticated-orcid":false,"given":"Catherine S.","family":"Stika","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Northwestern University's Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine L.","family":"Wisner","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Northwestern University's Feinberg School of Medicine  Chicago Illinois USA"},{"name":"Department of Psychiatry and Behavioral Sciences Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3993-966X","authenticated-orcid":false,"suffix":"Jr","given":"Alfred L.","family":"George","sequence":"additional","affiliation":[{"name":"Department of Pharmacology Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Avram","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katelyn","family":"Zumpf","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0820-7300","authenticated-orcid":false,"given":"Laura J.","family":"Rasmussen\u2010Torvik","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabrielle A.","family":"Mesches","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2169-0712","authenticated-orcid":false,"given":"Steve N.","family":"Caritis","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences University of Pittsburgh, Magee Womens Hospital  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raman","family":"Venkataramanan","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences University of Pittsburgh School of Pharmacy  Pittsburgh Pennsylvania USA"},{"name":"Department of Pathology University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maged M.","family":"Costantine","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology The Ohio State University Wexner Medical Center  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly A.","family":"West","sequence":"additional","affiliation":[{"name":"Department of OB\/GYN University of Texas Medical Branch  Galveston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon","family":"Clark","sequence":"additional","affiliation":[{"name":"Department of OB\/GYN University of Texas Medical Branch  Galveston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jody D.","family":"Ciolino","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,6]]},"reference":[{"key":"e_1_2_10_1_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000183597.31630.db"},{"issue":"51","key":"e_1_2_10_2_1","first-page":"e51","article-title":"Medication use during pregnancy, with particular focus on prescription drugs: 1976\u20102008","volume":"205","author":"Mitchell A.A.","year":"2011","journal-title":"Am. 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