Antidepressant use in pregnancy: knowledge transfer and translation of research findings.

Rationale: Knowledge transfer and translation (KT) has become an important component in health care systems worldwide. Antidepressant use in pregnancy has become a controversial subject for a number of reasons, including differing interpretations of study results.

Methods: Selected key articles were indentified and retrieved from the literature.

Antidepressant use in pregnancy: an evaluation of adverse outcomes excluding malformation.

Background: To date, many studies have been published regarding the safety of antidepressant use in pregnancy. However, most have been regarding a possible association with major malformations and there have been relatively few studies that have examined other infant outcomes specifically.

Objective: To evaluate possible adverse effects of antidepressant use in pregnancy.

Health literacy and its association with perception of teratogenic risks and health behavior during pregnancy.

Objective: Investigate the association between health literacy and perception of medication risk, beliefs about medications, use and non-adherence to prescribed pharmacotherapy during pregnancy, and whether risk perception and beliefs may mediate an association between health literacy and non-adherence.

Methods: This multinational, cross-sectional, internet-based study recruited pregnant woman between 1 October 2011 and 29 February 2012. Data on maternal socio-demographics, medication use, risk perception, beliefs, and non-adherence were collected via an on-line questionnaire.

Pregnancy outcome following in utero exposure to lithium: a prospective, comparative, observational study.

Objective: The authors conducted a prospective, comparative observational study to evaluate the risk of major anomalies following exposure to lithium during pregnancy.

Method: A total of 183 lithium-exposed pregnancies of women who contacted the Israeli Teratology Information Service were followed up (90.2% in the first trimester) and compared with 72 disease-matched and 748 nonteratogenic-exposed pregnancies.

Use of psychotropic medications during pregnancy: perception of teratogenic risk among physicians in two Latin American countries.

Objective: Pregnant women and their health care professionals commonly believe that use of medications during pregnancy may be harmful to the unborn fetus. The objective of this study was to evaluate the risk perception of psychotropic drug use in pregnancy among physicians in different medical specialties.

Method: This was a convenience survey conducted at outpatient clinics in the cities of Recife, Brazil, and La Plata, Bahía Blanca, and Buenos Aires, Argentina.

Risks of untreated depression in pregnancy.

Question: In my family practice, I tell my female patients of reproductive age who have depression that untreated depression in pregnancy might be more harmful than the unproven risks of antidepressants. However, I recently read in a national news magazine that there is actually no evidence for this advice. Have I missed something?

Answer: You did not miss anything, so you should continue to advise your pregnant patients as before.

Risk perception by healthcare professionals related to drug use during pregnancy: a Swiss survey.

Principle: Healthcare professionals' (HCPs') perception of risk associated with drug use in pregnancy may have an impact on the pharmacological treatment of some women. The aim of this study was to examine this risk perception in a sample of Swiss HCPs with a special focus on their knowledge and use of available specialised information sources.

Method: An online, French and German, questionnaire was e-mailed to 7,136 members of four Swiss professional societies (gynaecologists, paediatricians, midwives and pharmacists).

Managing depression during pregnancy.

Depression is a common illness during pregnancy, yet it often goes undetected and/or untreated. Untreated depression during pregnancy has been associated with increased rates of adverse maternal, obstetrical and fetal outcomes; consequently, it is crucial to manage these women effectively and adequately during this vulnerable time of their lives. The barriers to treatment include the stigma surrounding mental health and the challenges of navigating the constantly growing, and apparently conflicting, evidence regarding the safety of antidepressant use during pregnancy, as well as other concerns unique to pregnant women.

Antidepressant use during pregnancy: navigating the sea of information.

Question: When some of my patients who are taking antidepressants learn they are pregnant, they become anxious and confront me with the following statement: "I need this medication, but have heard so many conflicting stories from my friends and on the Internet and in the media that I am not sure if I should continue taking it." How do I advise them, as I have also seen conflicting evidence in the scientific literature?

Answer: To date, antidepressants are the most studied drugs during pregnancy, with more than 30 000 outcomes examining increased risks of adverse effects on exposed infants. The results of the studies can appear to be conflicting owing to differing interpretation of statistical analysis and subsequent knowledge transfer and translation of the information.

Pregnancy outcomes following gabapentin use: results of a prospective comparative cohort study.

Objectives: Our objectives were to 1) determine whether first-trimester use of gabapentin is associated with an increased risk for major malformations; 2) examine rates of spontaneous abortions, therapeutic abortions, stillbirths, mean birth weight and gestational age at delivery; and 3) examine rates of poor neonatal adaptation syndrome following late pregnancy exposure.

Methods: The study design was prospective. Women were included who initially contacted the services between 5 and 8 weeks with a comparison group of women exposed to nonteratogens, collected in a similar manner.

Challenges for healthcare providers in treating women with psychiatric disorders during pregnancy.

There continues to be a stigma surrounding mental illness, which includes women with psychiatric illnesses who become pregnant. In addition, both women and their health care providers often have an increased risk perception surrounding the safety of psychotropic drug use in pregnancy, resulting in physicians hesitant to prescribe and women afraid to take. Consequently, this creates many challenges and barriers when it comes to treating women pharmacologically during pregnancy and lactation.

Do findings differ across research design? The case of antidepressant use in pregnancy and malformations.

Background: Many studies examining the teratogenic potential of antidepressants have been published. A variety of observational designs have been used with apparent conflicting results, although odds ratios were rarely >2.

Objectives: To examine whether these apparent differences were associated with research methods such as model, comparison groups, data source, data collection procedures, definition of malformations, outcome ascertainment or management of confounders.

Antidepressant use in pregnancy and persistent pulmonary hypertension of the newborn (PPHN): a systematic review.

Background: An association between PPHN and antidepressant use in pregnancy has been reported.

Purpose: We sought to examine this relationship.

Methods: A review of the literature was performed, to evaluate this association.

Reliability and validity of the 4-item perceived stress scale among pregnant women: results from the OTIS antidepressants study.

We aimed to estimate the reliability of the 4-item Perceived Stress Scale (PSS) and its validity in predicting maternal depression and quality of life (QoL). Data regarding stress, depression and QoL were collected during pregnancy among a sub-sample from the Organization of Teratology Information Specialists Antidepressants in Pregnancy Cohort. The 4-item PSS demonstrated acceptable internal consistency (Cronbach's alpha coefficient = .

Human papillomavirus vaccine and pregnancy.

Unlabelled: QUESTION A: patient of mine who recently learned she was 6 weeks pregnant had received the recombinant human papillomavirus (HPV) quadrivalent vaccine at 4 weeks of gestation. She is quite worried about how this will affect her baby. What is known about the safety of the HPV vaccine during pregnancy?

Answer: The HPV vaccine is generally not recommended for use in pregnant women.

Pregnancy outcome after exposure to antidepressants and the role of maternal depression: results from the Norwegian Mother and Child Cohort Study.

Results of previous studies on the safety of antidepressants during pregnancy have been conflicting. The primary objective of this study was to investigate whether first-trimester exposure to antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs), was associated with increased risk of congenital malformations. The secondary objective was to examine the effects of exposure to antidepressants during pregnancy on birth weight and gestational age.