1. Objectifs

Intentions :
This study explores «the association between AD [antidepressant] use and the incidence of GDM [gestational diabetes mellitus] in pregnancy.» (p. 2)

2. Méthode

Échantillon/Matériau :
«A nested case–control study was conducted within the Quebec Pregnancy Cohort (QPC). The QPC is an ongoing population-based cohort with prospective data collection on all pregnancies insured by the Quebec Public Prescription Drug Insurance Plan, from 1998 to 2015. […] Data sources for this study comprised the medical service database (RAMQ: diagnoses and medical procedures), the Quebec Prescription Drug Insurance Database (drug name, start date, dosage and duration), the Hospitalisation Archive Database (MedEcho: in-hospital diagnoses and procedures) and the Quebec Statistics Database (Institut de la statistique du Québec (ISQ): patient sociodemographic information).» (p. 2)

Type de traitement des données :
Analyse statistique

3. Résumé

«In this study, overall AD use was associated with an increased risk for GDM. Specifically, venlafaxine and amitriptyline were associated with a 27% and 52% increased risk of GDM, respectively, after adjustment for major confounders and underlying conditions. No statistically significant association was observed with any SSRI [selective serotonin reuptake inhibitors]. Moreover, [the authors] found a cumulative duration effect for short, medium and long duration of AD use, which was associated with a 15%, 17% and 29% increased risk of having GDM, respectively. This effect varied within classes of ADs.» (p. 5) The results of this study confirm that the «treatment of depression during pregnancy is a major concern and is challenging because depression is prevalent before and during pregnancy, and untreated depression can lead to relapse during pregnancy and in the postpartum period. Hence, adverse outcomes associated with AD use during pregnancy including GDM should be weighed against the consequences of non-medicated depression, especially for women with severe depression.» (p. 9)