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Social determinants of antidepressant continuation during pregnancy in the USA: findings from the ABCD cohort study

Authors: Dupuis, Marc; Weir, Kristie Rebecca; Vidonscky Lüthold, Renata; Panchaud Monnat, Alice Elke Martine; Baggio, Stéphanie;

Social determinants of antidepressant continuation during pregnancy in the USA: findings from the ABCD cohort study

Abstract

Abstract Purpose Patients and healthcare professionals overestimate the risks of using antidepressants during pregnancy. According to current literature, approximately half of people stop taking an anti-depressant medication when they become pregnant. Discontinuing antidepressants during pregnancy increases risks of postnatal relapses. Factors like socioeconomic status, education, and planned pregnancies play a role in the decision to continue antidepressant medication, which can worsen disparities in maternal and child health. Our aim was to identify the sociodemographic factors associated with antidepressant continuation after awareness of pregnancy. Methods We used representative data from the Adolescent Brain Cognitive Development (ABCD) study that captures maternal medication during pregnancy. We identified women who used antidepressants before awareness of their pregnancy. We calculated crude and adjusted associations between sociodemographic factors and continuation of antidepressant medication during pregnancy. Our model included age, education, ethnicity, first language, household income, living with a partner, having planned the pregnancy, pregnancy duration and smoking during pregnancy. Results In total, 199 women continued antidepressants and 100 discontinued. The logistic regressions resulted in only one significant factor: first language. Native English speakers were more likely to continue medication than other mothers (adjusted OR = 14.94, 95% CI = [2.40; 291.45], p = .015). Conclusions Language differences were associated with continuation of antidepressants. Non-native English speakers were more likely to discontinue antidepressants, which may lead to health inequities. This finding should be taken into account to reinforce information about the limited risks of antidepressants among people with non-English speaking backgrounds in the USA.

Keywords

Adult, Adolescent, Antidepressants Continuation Discontinuation Pregnancy Social determinants, Social Determinants of Health, Depression, 610 Medicine & health, Antidepressive Agents, United States, Humans; Female; Pregnancy; Antidepressive Agents/therapeutic use; Adult; United States/epidemiology; Cohort Studies; Adolescent; Pregnancy Complications/drug therapy; Social Determinants of Health; Young Adult; Socioeconomic Factors; Depression/drug therapy; Depression/epidemiology; Antidepressants; Continuation; Discontinuation; Social determinants, Cohort Studies, Pregnancy Complications, Young Adult, Socioeconomic Factors, 360 Social problems & social services, Pregnancy, Humans, Original Article, Female

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
1
Average
Average
Average
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hybrid