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Antidepressant Use During Pregnancy Linked to Increased Risk of Hypertensive Disorders
A recent study published in Hypertension has revealed a significant association between antidepressant medication use during pregnancy and an elevated risk of gestational hypertension and preeclampsia. The research, analyzing data from over 1.7 million pregnancies in Denmark,found that women who continued antidepressant treatment throughout their pregnancy faced a 35% higher risk of developing gestational hypertension and a 28% increased risk of preeclampsia compared to those who were not taking antidepressants.
The study, conducted by researchers at the University of Copenhagen, examined national registry data encompassing pregnancies between 1995 and 2016. Researchers categorized women into four groups: those who discontinued antidepressants before conception, those who discontinued during the first trimester, those who continued throughout pregnancy, and those who never used antidepressants. The findings indicated that discontinuing antidepressants before conception did not demonstrate a statistically significant increase in hypertensive disorders.
Specifically, the incidence of gestational hypertension was 4.8% among women who continued antidepressants during pregnancy, compared to 3.5% in the reference group (those who never used antidepressants). For preeclampsia, the incidence was 1.8% in the continued-antidepressant group versus 1.4% in the reference group. Discontinuation during the first trimester showed a smaller, but still notable, increase in risk compared to the reference group.
the study authors, led by Dr. Xiaoyu Li, emphasize that the observed association does not establish causation. ”It is indeed critically important to note that this is an observational study, and thus cannot prove that antidepressants directly cause gestational hypertension or preeclampsia,” Dr. Li stated in the published research. “However, the findings suggest a potential link that warrants further examination.”
Gestational hypertension, characterized by high blood pressure developing after 20 weeks of pregnancy, and preeclampsia, a more severe condition involving high blood pressure and signs of organ damage, pose significant risks to both mother and baby. Preeclampsia can lead to serious complications such as seizures, stroke, and even maternal or fetal death.
Previous research has explored the potential impact of antidepressant use on pregnancy outcomes. A 2016 study published in Archives of Women’s Mental Health by Ocampo, Araneta, Macera, Alcaraz, moore, and Chambers investigated the risk of gestational hypertension and preeclampsia in women who discontinued or continued antidepressant medication during pregnancy, adding to the growing body of evidence on this topic.
Understanding the underlying mechanisms driving this potential association is crucial. Phipps,Thadhani,Benzing,and Karumanchi,in their 2019 review published in nature Reviews Nephrology,detailed the pathogenesis,novel diagnostics,and therapies for pre-eclampsia,highlighting the complex interplay of factors involved in the progress of this condition. Further research is needed to determine whether the observed link between antidepressants and hypertensive disorders is due to the medication itself, underlying mental health conditions, or other confounding factors.
The researchers recommend that women considering pregnancy who are taking antidepressants should discuss the potential risks and benefits with their healthcare providers. Careful consideration should be given to the individual patient’s mental health history, the severity of their depression or anxiety, and the potential consequences of both continuing and discontinuing medication.
References:
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Li X, et al. Antidepressant use during pregnancy and risk of gestational hypertension and preeclampsia: A population-based cohort study. Hypertension. 2024;83(3