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Depression affects approximately 30% of reproductive-aged women, and untreated depression is associated with adverse maternal and neonatal outcomes. However, use of some antidepressants during pregnancy has been associated with a slight increase in risk for certain congenital anomalies (e.g., NEJM JW Womens Health Feb 2012 and BMJ 2012; 344:d8012). To estimate the frequency of antidepressant use by women during their childbearing years (age range, 15–44), the CDC analyzed prescription data from a private insurance claims database that included >4 million women between 2008 and 2013.
Overall, 15.4% of women filled a prescription for an antidepressant. Percentages rose with age from 8.3% (age range, 15–19) to 20.9% (40–44). Among antidepressants, sertraline was most often prescribed (3.3%).
Dawson AL et al. Antidepressant prescription claims among reproductive-aged women with private employer-sponsored insurance — United States 2008–2013. MMWR Morb Mortal Wkly Rep 2016 Jan 29; 65:41. (http://dx.doi.org/10.15585/mmwr.mm6503a1)
Comment
As screening for depression is now universally recommended, the proportion of women who receive pharmacologic therapy is likely to increase. For recent findings on individual medications and pregnancy outcomes, see BMJ 2015; 351:h3190. Additional large studies will be essential to help us effectively counsel women about the benefits and risks of antidepressant use during pregnancy. In each case, this risk needs to be balanced against the harms of untreated maternal depression and its toll on women and their families.