Association between Antidepressant Treatment during Pregnancy and Postpartum Self-Harm Ideation in Women with Psychiatric Disorders: A Cross-Sectional, Multinational Study

Jennifer Vallee, Yih Wong, Eline Mannino, Hedvig Nordeng and Angela Lupattelli
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Jennifer Vallee: PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, 0316 Oslo, Norway
Yih Wong: PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, 0316 Oslo, Norway
Eline Mannino: PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, 0316 Oslo, Norway
Hedvig Nordeng: PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, 0316 Oslo, Norway
Angela Lupattelli: PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, 0316 Oslo, Norway

IJERPH, 2020, vol. 18, issue 1, 1-15

Abstract: This study sought to estimate whether there is a preventative association between antidepressants during pregnancy and postpartum self-harm ideation (SHI), as this knowledge is to date unknown. Using the Multinational Medication Use in Pregnancy Study, we included a sample of mothers who were in the five weeks to one year postpartum period at the time of questionnaire completion, and reported preexisting or new onset depression and/or anxiety during pregnancy ( n = 187). Frequency of postpartum SHI (‘often/sometimes’ = frequent, ‘hardly ever’ = sporadic, ‘never’) was measured via the Edinburgh Postnatal Depression Scale (EPDS) item 10, which reads “ The thought of harming myself has occurred to me ”. Mothers reported their antidepressant use in pregnancy retrospectively. Overall, 52.9% of women took an antidepressant during pregnancy. Frequent SHI postpartum was reported by 15.2% of non-medicated women and 22.0% of women on past antidepressant treatment in pregnancy; this proportion was higher following a single trimester treatment compared to three trimesters (36.3% versus 18.0%). There was no preventative association of antidepressant treatment in pregnancy on reporting frequent SHI postpartum (weighted RR: 1.90, 95% CI: 0.79, 4.56), relative to never/hardly ever SHI. In a population of women with antenatal depression/anxiety, there was no preventative association between past antidepressant treatment in pregnancy and reporting frequent SHI in the postpartum year. This analysis is only a first step in providing evidence to inform psychiatric disorder treatment decisions for pregnant women.

Keywords: antidepressants; pharmacotherapy; pregnancy; postpartum; self-harm ideation; web-based (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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