{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T22:19:11Z","timestamp":1784672351948,"version":"3.55.0"},"reference-count":60,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,17]],"date-time":"2024-11-17T00:00:00Z","timestamp":1731801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000026","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":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Given the high prevalence of both mental health and acute pain conditions during pregnancy, use of antidepressants and analgesic opioids in this period is widespread. Whether single and combined use of these medications is associated with spontaneous preterm birth (sPTB) remains unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To investigate the association between maternal prescription opioid and antidepressant medication exposures for co\u2010occurring mental health and acute pain management, either alone or in combination, and sPTB.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used Tennessee Medicaid data (2007\u20132019) linked to birth certificates to conduct a nested case\u2013control study among 15\u2010 to 44\u2010year\u2010old pregnant patients with singleton live births. Cases were identified as spontaneous live births between 24 and &lt;37 gestational weeks using a validated birth certificate\u2010based algorithm. We selected up to 10 controls per case, matched on estimated pregnancy start date and other factors. We identified analgesic opioid and antidepressant pharmacy fills to define medication exposures in the 60\u2009days before index date (case delivery date) and categorised them as unexposed, opioid\u2010only, antidepressant\u2010only and combined exposure. We estimated odds ratios (OR) and 95% confidence intervals (CI) using conditional logistic regression, adjusting for confounders. We assessed the additive interaction between opioids and antidepressants by estimating relative excess risk due to interaction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 25,406 eligible cases of sPTB and 225,771 matched controls. Opioid\u2010only and combined exposures were associated with higher odds of sPTB relative to unexposed (adjusted OR 1.29, 95% CI 1.23, 1.35 and 1.22, 95% CI 1.06, 1.40, respectively), while antidepressant\u2010only exposure was not (1.04, 95% CI 0.96, 1.12). No additive interaction was identified for combined exposure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Exposure to prescription opioids during pregnancy, but not antidepressants, was associated with increased relative odds of sPTB. Co\u2010exposure to opioids and antidepressants did not elevate the odds of sPTB above what we observed for opioid\u2010only exposure.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.13142","type":"journal-article","created":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T03:29:38Z","timestamp":1731900578000},"page":"97-106","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Opioid analgesic and antidepressant use during pregnancy and\u00a0the risk of spontaneous preterm birth: A nested case\u2013control study"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7366-7107","authenticated-orcid":false,"given":"Maria C.","family":"Padilla\u2010Azain","sequence":"first","affiliation":[{"name":"Department of Health Policy Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah S.","family":"Osmundson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Bosworth","sequence":"additional","affiliation":[{"name":"Vanderbilt University  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Wiese","sequence":"additional","affiliation":[{"name":"Department of Health Policy Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelie","family":"Pham","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley A.","family":"Leech","sequence":"additional","affiliation":[{"name":"Department of Health Policy 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