{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T02:15:32Z","timestamp":1793153732004,"version":"4.5.0"},"reference-count":50,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,3,24]],"date-time":"2020-03-24T00:00:00Z","timestamp":1585008000000},"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":["R00HD082412"],"award-info":[{"award-number":["R00HD082412"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Paediatric Perinatal Epid"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Antidepressant use later in pregnancy has been associated with preeclampsia and postpartum haemorrhage (PPH) in some studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the association between patterns of prenatal antidepressant dose across gestationand risk of precclampsia and PPH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We utilised OptumLabs\u00ae Data Warehouse (2012\u20102016) administrative health care claims, identifying 226\u00a0932 singleton liveborn deliveries for this retrospective cohort study. Antidepressant dispensing doses were converted to fluoxetine equivalents. Using k\u2010means longitudinal, we identified women with similar patterns of antidepressant exposure, that is, trajectory groups, during the first 20 and 35 gestational weeks. We estimated risk ratios (RR) and 95% confidence intervals (CI) for the association between trajectory groups and preeclampisa (20\u2010week groups) and PPH (35\u2010week groups), adjusting for demographics, co\u2010morbidities, and other psychotropic medications. Linear trend tests assessing increasing risk of the outcomes across groups were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 15\u00a0041 (6.6%) pregnancies exposed to an antidepressant, the following trajectory groups were identified: A\u2010low exposure, starting pregnancy at ~10\u00a0mg\/d, with 1st trimester reduction\/discontinuation, B\u2010low sustained exposure of ~20\u00a0mg\/d, C\u2010moderate exposure (~40\u00a0mg\/d) with 1st trimester reduction\/discontinuation, D\u2010moderate sustained exposure of ~40\u00a0mg\/d, and E\u2010high sustained exposure of ~75\u00a0mg\/d. In the low exposure with reduction\/discontinuation trajectory, risks were 8.2% for preeclampsia and 2.7% for PPH. Compared with this group, low, moderate, and high sustained trajectories were associated with preeclampsia (adjusted RR 1.17, 95% CI 1.01, 1.34; RR 1.31, 95% CI 1.12, 1.54; and RR 1.41, 95% CI 1.05, 1.90, respectively) and PPH (RR 1.32, 95% CI 1.05, 1.66; RR 1.35, 95% CI 1.03, 1.78; RR 2.51, 95% CI 1.69, 3.71, respectively); <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01 for linear trend tests for both outcomes. There was no increased risk for either outcome for moderate exposure with reduction\/discontinuation\u00a0(trajectory C).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Women with sustained antidepressant exposure, especially at higher doses, were at increased risk for preeclampsia and PPH, but\u00a0underlying depression and anxiety may contribute to the increased risk.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.12660","type":"journal-article","created":{"date-parts":[[2020,3,24]],"date-time":"2020-03-24T09:29:28Z","timestamp":1585042168000},"page":"597-606","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Patterns of prenatal antidepressant exposure and risk of preeclampsia and postpartum 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2167-8921","authenticated-orcid":false,"given":"Gretchen","family":"Bandoli","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of California San Diego La Jolla CA USA"},{"name":"OptumLabs Visiting Fellow Cambridge MA USA"},{"name":"Department of Family Medicine and Public Health University of California San Diego La Jolla CA 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