Maternal and Infant Effects of Treated and Untreated Depression During Pregnancy

怀孕期间治疗和未治疗抑郁症对母婴的影响

• 批准号: 7136024
• 负责人: Tina V Hartert
• 金额: $ 7.65万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-08-10 至 2008-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7136024
• 关键词: Medicare /Medicaid; antidepressants; behavioral /social science research tag; child rearing; clinical research; depression; disease /disorder proneness /risk; dosage; drug adverse effect; early experience; health services research tag; hospital utilization; human data; low socioeconomic status; mental disorder chemotherapy; mental health epidemiology; newborn human (0-6 weeks); parent offspring interaction; patient care planning; pregnancy; pregnancy disorder; psychosis; suicide

DESCRIPTION (provided by applicant): This proposal is in response to an NIMH program announcement on women's mental health in pregnancy and the postpartum period and addresses several goals of the program by investigating the epidemiology, risk factors, and effects of treatment on depression during pregnancy. Ten to fifteen percent of women experience some degree of depression during pregnancy and these women are at higher risk of depression following childbirth and later in life. Maternal depression during pregnancy may have adverse effect on pregnancy and neonatal outcomes, and on-going maternal depression is known to have adverse effects on parenting and family function. To help determine the best course of treatment for depression among pregnant women, this study will analyze provider, pharmacy, and hospital claims data from the Tennessee Medicaid (TennCare) population from 1994-2003. This large population includes over half of all Tennessee births during the study period. The proposed study makes efficient use of existing data and infrastructure to study the relationship of treated and untreated depression on maternal and infant outcomes, which will help guide both future clinical research and current medical practice. The central hypothesis is that there are no measurable harmful effects of pharmacotherapy for depression during pregnancy with regards to specific pregnancy, perinatal, and depression outcomes. To determine whether women who take antidepressants during pregnancy have increased rates of adverse pregnancy and perinatal outcomes, we will perform a retrospective cohort analysis in otherwise healthy pregnant women to evaluate pregnancy and perinatal outcomes by exposure to specific antidepressant medications. We will perform a second retrospective cohort study of women with recognized depression prior to pregnancy. Women will be classified as exposed or unexposed to antidepressants and we will quantify the risks of adverse pregnancy, perinatal, and depression outcomes by antidepressant treatment status after adjusting for markers of depression severity. The second proposed retrospective cohort is an innovative analysis that will use a subset of the very large population to evaluate the relative risks of treating depression during pregnancy. Results of the proposed analysis will help women and their health care providers decide how to manage depression during pregnancy and guide future research. Understanding the impact of treated and untreated depression during pregnancy is very important to public health, specifically the well being of the mother, healthy fetal development, and the development of a healthy mother-infant relationship.

描述（由申请人提供）：本提案是对 NIMH 关于女性怀孕期和产后心理健康的计划公告的回应，并通过调查流行病学、危险因素以及治疗对怀孕期间抑郁症的影响来实现该计划的几个目标。百分之十到十五的女性在怀孕期间经历过某种程度的抑郁症，这些女性在分娩后和以后的生活中患抑郁症的风险更高。怀孕期间的母亲抑郁可能会对妊娠和新生儿结局产生不利影响，而持续的母亲抑郁会对养育子女和家庭功能产生不利影响。为了帮助确定孕妇抑郁症的最佳治疗方案，本研究将分析 1994 年至 2003 年田纳西州医疗补助 (TennCare) 人群的提供者、药房和医院索赔数据。这一庞大的人口占研究期间田纳西州出生人口的一半以上。拟议的研究有效利用现有数据和基础设施来研究治疗和未治疗的抑郁症与母婴结局的关系，这将有助于指导未来的临床研究和当前的医疗实践。中心假设是，对于特定的妊娠、围产期和抑郁结局，妊娠期间抑郁症的药物治疗没有可测量的有害影响。为了确定怀孕期间服用抗抑郁药物的女性是否会增加不良妊娠和围产期结局的发生率，我们将对其他方面健康的孕妇进行回顾性队列分析，通过接触特定抗抑郁药物来评估妊娠和围产期结局。我们将对怀孕前患有抑郁症的女性进行第二项回顾性队列研究。女性将被分为暴露或未暴露于抗抑郁药物的两类，我们将在调整抑郁严重程度的标志后，通过抗抑郁治疗状态来量化不良妊娠、围产期和抑郁结局的风险。第二个拟议的回顾性队列是一项创新分析，将使用大量人群的子集来评估怀孕期间治疗抑郁症的相对风险。拟议分析的结果将帮助妇女及其医疗保健提供者决定如何管理怀孕期间的抑郁症并指导未来的研究。了解怀孕期间治疗和未经治疗的抑郁症的影响对于公共健康，特别是母亲的福祉、胎儿的健康发育以及健康的母婴关系的发展非常重要。