The international prevalence of antidepressant use before, during, and after pregnancy: A systematic review and meta-analysis of timing, type of prescriptions and geographical variability

•The international prevalence estimate of SSRIs during pregnancy is 3.0%.%•There are substantial regional differences in antidepressant use during pregnancy.•There is an urgent need for evidence on the effectiveness during pregnancy. Antidepressant use during pregnancy has increased over the last de...

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Bibliographic Details
Published in:Journal of affective disorders 2020-03, Vol.264, p.82-89
Main Authors: Molenaar, Nina M., Bais, Babette, Lambregtse-van den Berg, Mijke P., Mulder, Cornelis L., Howell, Elizabeth A., Fox, Nathan S., Rommel, Anna-Sophie, Bergink, Veerle, Kamperman, Astrid M.
Format: Article
Language:English
Subjects:
Antidepressants
Antidepressive Agents - adverse effects
Epidemiology
Europe
Female
Humans
Meta-analysis
North America
Pregnancy
Prescriptions
Prevalence
Serotonin Uptake Inhibitors - adverse effects
Systematic review
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Summary:•The international prevalence estimate of SSRIs during pregnancy is 3.0%.%•There are substantial regional differences in antidepressant use during pregnancy.•There is an urgent need for evidence on the effectiveness during pregnancy. Antidepressant use during pregnancy has increased over the last decades, while safety has been under debate. Our aim was to measure the international prevalence of antidepressant use before, during, and after pregnancy and examine timing, type of prescriptions and geographic variability. We searched Embase, Medline Ovid, Web of Science, Cochrane Central and Google Scholar from their inception until February 19, 2019. We determined pooled prevalence estimates of antidepressants before, during, and after pregnancy, as well as stratified according to substantive variables. We identified 40 cohorts from 15 countries, together reporting on 14,072,251 pregnancies. Included studies had a low risk of bias, often reporting on large representative cohorts. Selective serotonin reuptake inhibitors (SSRIs) were the most commonly used antidepressants during pregnancy, with an international prevalence estimate of 3.0% (95%CI 2.3;3.7). While Europe and Australasia had pooled prevalence estimates of 1.6% and 1.3% respectively, Northern America had a prevalence estimate of 5.5% (Q-value = 126.19; df = 2; p-value
ISSN:0165-0327
1573-2517
DOI:10.1016/j.jad.2019.12.014