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Abstract
Background
While medications for anxiety and depression are commonly used in the United States, it is unclear to what degree they are continued during pregnancy.
Methods
We used a large administrative database to determine whether psychiatric medications are continued during pregnancy and predictors of continued medication treatment.
Results
Of 2,672,656 women included in our analysis, 86,454 (3.1%) filled a pre-pregnancy prescription for an anxiolytic or antidepressant medication within 3 months of estimated conception. Of women who filled a pre-pregnancy prescription, 49.4%, 26.1%, and 20.1% filled subsequent prescriptions in the 1st, 2nd, and 3rd trimesters. Discontinuation rates ranged by pharmaceutical agent, from 16% for fluoxetine to 71% for alprazolam. White women and women over 25 were more likely to continue anxiolytic and antidepressant treatment during pregnancy.
Conclusion
Because untreated and under-treated mental health conditions are linked to adverse maternal outcomes, high discontinuation rates may have important implications for maternal health.
Disclosure statement
Dr. D’Alton has had a leadership role in ACOG II’s Safe Motherhood Initiative which has received unrestricted funding from Merck for Mothers. Dr. Wright has served as a consultant for Clovis Oncology and received research funding from Merck. Timothy Wen disclosed that money was paid to him from Delfina Care, Inc. The other authors did not report any potential conflicts of interest.