{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:43:06Z","timestamp":1787013786619,"version":"build-2736575974"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T00:00:00Z","timestamp":1648771200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008267","name":"Kong Christian den Tiendes Fond","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008267","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Psychiatr Scand"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the association between mirtazapine exposure in pregnancy and risk of specific adverse pregnancy outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A register\u2010based nationwide cohort study was conducted including all registered pregnancies in Denmark from 1997 to 2016. Mirtazapine\u2010exposed pregnancies were compared with mirtazapine unexposed pregnancies in a 1:4 ratio matched according to propensity scores. Outcomes were major congenital malformations analyzed using log binomial models, and spontaneous abortion, stillbirth and neonatal death analyzed using Cox proportional hazard regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From a source population of 1,650,649 pregnancies, the propensity score\u2010matched cohort included 4475 pregnancies (895\u00a0mirtazapine exposed) in the analysis of major congenital malformations. The analyses of spontaneous abortion included 9 500 pregnancies (1900\u00a0mirtazapine exposed), and for the analyses of stillbirths and neonatal deaths 9725 (1 945\u00a0mirtazapine\u2010exposed) and 4485 pregnancies (897\u00a0mirtazapine\u2010exposed) were included, respectively. Thirty\u2010one (3.5%) children were diagnosed with major congenital malformation among the mirtazapine exposed compared with 152 (4.3%) among the unexposed pregnancies (OR=0.81, 95% CI 0.55\u20131.20). Spontaneous abortion occurred in 237 (12.5%) of the mirtazapine exposed compared with 931 (12.3%) of the unexposed pregnancies (HR\u00a0=\u00a01.04%, 95% CI 0.91\u20131.20). The analyses revealed no increased risk of stillbirth (HR\u00a0=\u00a00.88%, 95% CI 0.34\u20132.29) or neonatal death (HR\u00a0=\u00a00.60%, 95% CI 0.18\u20132.02).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this nationwide Danish register study, mirtazapine exposure in pregnancy was not associated with major congenital malformations, spontaneous abortion, stillbirth, or neonatal death. Clinicians and patients can be reassured that mirtazapine is safe in pregnancy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acps.13431","type":"journal-article","created":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T14:34:16Z","timestamp":1648046056000},"page":"557-567","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Mirtazapine exposure in pregnancy and fetal safety: A nationwide cohort study"],"prefix":"10.1111","volume":"145","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7909-5107","authenticated-orcid":false,"given":"Anne","family":"Ostenfeld","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Copenhagen University Hospital Nordsj\u00e6llands Hospital  Hiller\u00f8d Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tonny Studsgaard","family":"Petersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Clinical Pharmacology Bispebjerg and Frederiksberg Hospital Copenhagen University Hospital  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars Henning","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Department of Biomedicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanne Brix","family":"Westergaard","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Copenhagen University Hospital Nordsj\u00e6llands Hospital  Hiller\u00f8d Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen Christine Leth","family":"L\u00f8kkegaard","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Copenhagen University Hospital Nordsj\u00e6llands Hospital  Hiller\u00f8d Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon Tr\u00e6rup","family":"Andersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Clinical Pharmacology Bispebjerg and Frederiksberg Hospital Copenhagen University Hospital  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2017.05.003"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroscience.2015.09.001"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/13651501.2017.1306082"},{"issue":"5","key":"e_1_2_9_5_1","first-page":"427","volume":"23","author":"Croom KF","year":"2009","journal-title":"Mirtazapine: A Review of its Use in Major Depression and Other Psychiatric Disorders"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1517\/14656566.2011.585459"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0000000000001164"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00737-016-0707-4"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/JCP.0000000000000656"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-034712"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2015.06.014"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0072095"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471\u20100528.13164"},{"issue":"3","key":"e_1_2_9_14_1","first-page":"320","article-title":"The danish medical birth registry","volume":"45","author":"Knudsen LB","year":"1998","journal-title":"Dan Med Bull"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494811401482"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494810394717"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494810387965"},{"key":"e_1_2_9_18_1","unstructured":"EUROCAT Guide 1.4 and Reference Documents EUROCAT (2013).EUROCAT guide 1.4: instruction for the registration of congenital anomalies EUROCAT Guide 1.4 and reference documents (Last update version 28\/12\/2018)[Internet]. 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