Antidepressant use during pregnancy and the risk of gestational diabetes mellitus: a nested case–control study

Objectives The aim of this study was to determine the association between antidepressant (AD) classes, types and duration of use during pregnancy and the risk of gestational diabetes mellitus (GDM).Design and setting A nested case–control study was conducted within the Quebec Pregnancy Cohort (QPC),...

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Main Authors: Maëlle Dandjinou, Odile Sheehy, Anick Bérard
Format: Article
Language:English
Published: BMJ Publishing Group 2019-09-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/9/e025908.full
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author Maëlle Dandjinou
Odile Sheehy
Anick Bérard
author_facet Maëlle Dandjinou
Odile Sheehy
Anick Bérard
author_sort Maëlle Dandjinou
collection DOAJ
description Objectives The aim of this study was to determine the association between antidepressant (AD) classes, types and duration of use during pregnancy and the risk of gestational diabetes mellitus (GDM).Design and setting A nested case–control study was conducted within the Quebec Pregnancy Cohort (QPC), a Canadian provincial database which includes data on all pregnancies and children in Quebec from January 1998 to December 2015.Primary outcome measures Gestational diabetes mellitus.Participants Cases of GDM were identified after week 20 of pregnancy and randomly matched 1:10 to controls on gestational age at index date (ie, calendar date of GDM) and year of pregnancy. AD exposure was assessed by filled prescriptions between the beginning of pregnancy (first day of last menstrual period) and index date. Conditional logistic regression models were used to estimate crude and adjusted odds ratios (aOR).Results Among 20 905 cases and 209 050 matched controls, 9741 (4.2%) women were exposed to ADs. When adjusting for potential confounders, AD use was associated with an increased risk of GDM (aOR 1.19, 95% CI 1.08 to 1.30); venlafaxine (aOR 1.27, 95% CI 1.09 to 1.49) and amitriptyline (aOR 1.52, 95% CI 1.25 to 1.84) were also associated with an increased risk of GDM. Moreover, the risk of GDM was increased with longer duration of AD use, specifically for serotonin norepinephrine reuptake inhibitors, tricyclic ADs and combined use of two AD classes. No statistically significant association was observed for selective serotonin reuptake inhibitors.Conclusion The findings suggest that ADs—and specifically venlafaxine and amitriptyline—were associated with an increased risk of GDM.
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spelling doaj-art-4a7a037dd71e44ebbac183a63542b3da2025-08-20T02:07:30ZengBMJ Publishing GroupBMJ Open2044-60552019-09-019910.1136/bmjopen-2018-025908Antidepressant use during pregnancy and the risk of gestational diabetes mellitus: a nested case–control studyMaëlle Dandjinou0Odile Sheehy1Anick Bérard21 Research Center, CHU Sainte-Justine, Montreal, Quebec, Canada1 Research Center, CHU Sainte-Justine, Montreal, Quebec, Canada1 Research Center, CHU Sainte-Justine, Montreal, Quebec, CanadaObjectives The aim of this study was to determine the association between antidepressant (AD) classes, types and duration of use during pregnancy and the risk of gestational diabetes mellitus (GDM).Design and setting A nested case–control study was conducted within the Quebec Pregnancy Cohort (QPC), a Canadian provincial database which includes data on all pregnancies and children in Quebec from January 1998 to December 2015.Primary outcome measures Gestational diabetes mellitus.Participants Cases of GDM were identified after week 20 of pregnancy and randomly matched 1:10 to controls on gestational age at index date (ie, calendar date of GDM) and year of pregnancy. AD exposure was assessed by filled prescriptions between the beginning of pregnancy (first day of last menstrual period) and index date. Conditional logistic regression models were used to estimate crude and adjusted odds ratios (aOR).Results Among 20 905 cases and 209 050 matched controls, 9741 (4.2%) women were exposed to ADs. When adjusting for potential confounders, AD use was associated with an increased risk of GDM (aOR 1.19, 95% CI 1.08 to 1.30); venlafaxine (aOR 1.27, 95% CI 1.09 to 1.49) and amitriptyline (aOR 1.52, 95% CI 1.25 to 1.84) were also associated with an increased risk of GDM. Moreover, the risk of GDM was increased with longer duration of AD use, specifically for serotonin norepinephrine reuptake inhibitors, tricyclic ADs and combined use of two AD classes. No statistically significant association was observed for selective serotonin reuptake inhibitors.Conclusion The findings suggest that ADs—and specifically venlafaxine and amitriptyline—were associated with an increased risk of GDM.https://bmjopen.bmj.com/content/9/9/e025908.full
spellingShingle Maëlle Dandjinou
Odile Sheehy
Anick Bérard
Antidepressant use during pregnancy and the risk of gestational diabetes mellitus: a nested case–control study
BMJ Open
title Antidepressant use during pregnancy and the risk of gestational diabetes mellitus: a nested case–control study
title_full Antidepressant use during pregnancy and the risk of gestational diabetes mellitus: a nested case–control study
title_fullStr Antidepressant use during pregnancy and the risk of gestational diabetes mellitus: a nested case–control study
title_full_unstemmed Antidepressant use during pregnancy and the risk of gestational diabetes mellitus: a nested case–control study
title_short Antidepressant use during pregnancy and the risk of gestational diabetes mellitus: a nested case–control study
title_sort antidepressant use during pregnancy and the risk of gestational diabetes mellitus a nested case control study
url https://bmjopen.bmj.com/content/9/9/e025908.full
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