{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T03:03:47Z","timestamp":1777950227375,"version":"3.51.4"},"reference-count":44,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2022,10,1]],"date-time":"2022-10-01T00:00:00Z","timestamp":1664582400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Women's Health"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Women service members of the past 20 years experienced high rates of traumatizing events resulting in pharmacological treatment. Post-military lives may include having children. Typically, Veterans Health Administration (VHA) patients' pregnancies are managed outside the VHA. This study examined medication exposures during pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>The Center for Maternal and Infant Outcomes Research in Translation (COMFORT) study collected primary survey data and linked secondary health care data from the VHA from 2015 to 2021. Medication fills and covariates were extracted for three 9-month periods: preconception, pregnancy, and postpartum. Multiple regression assessed factors associated with use during pregnancy of selective serotonin reuptake inhibitor (SSRI)\/serotonin norepinephrine reuptake inhibitor (SNRI) or of non-recommended, potentially risky drugs, and of discontinuation of those medications from prepregnancy to pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The cohort comprised 501 women\u201429% Black, 65% White, and 6% other races, of whom 63% had 50%\u2013100% service-connected disability. During pregnancy, 36% had a pain-related disorder, 19% major depression, and 18% post-traumatic stress disorder. The median number of drug classes prescribed during pregnancy was 5. The use of SSRI\/SNRI antidepressants dropped from 36% preconception to 26% during pregnancy including new starts; 15% discontinued SSRI\/SNRI. Comorbidity predicted medication use. Depression predicted discontinuing SSRI\/SNRI during pregnancy; no predictors of discontinuing potentially risky drugs were identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Based on prescriptions filled within the VHA only\u2014ignoring potential community-based fills\u2014women veterans were prescribed numerous medications during pregnancy and discontinued antidepressants alarmingly. Veterans of childbearing potential should receive counseling about medication use before pregnancy occurs. Their non-VHA obstetricians and VHA providers should share information to optimize outcomes, reviewing medications as soon as pregnancy is detected as well as after pregnancy concludes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/jwh.2021.0529","type":"journal-article","created":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T11:41:38Z","timestamp":1648640498000},"page":"1450-1458","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Medications with Potential for Fetal Risk Prescribed to Veterans"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9478-0209","authenticated-orcid":false,"given":"Laurel A.","family":"Copeland","sequence":"first","affiliation":[{"name":"Research Service, VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts, USA."},{"name":"Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca L.","family":"Kinney","sequence":"additional","affiliation":[{"name":"Research Service, VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts, USA."},{"name":"Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aimee R.","family":"Kroll-Desrosiers","sequence":"additional","affiliation":[{"name":"Research Service, VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts, USA."},{"name":"Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geetha","family":"Shivakumar","sequence":"additional","affiliation":[{"name":"Research Service, VA North Texas Health Care System, Dallas, Texas, USA."},{"name":"Department of Psychiatry, UT Southwestern Medical Center, Dallas, Texas, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6012-3008","authenticated-orcid":false,"given":"Kristin M.","family":"Mattocks","sequence":"additional","affiliation":[{"name":"Research Service, VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts, USA."},{"name":"Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,10,26]]},"reference":[{"key":"e_1_3_6_2_2","unstructured":"Department of Veterans Affairs. 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