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Social determinants in prenatal antidepressant use and continuation: Systematic review and meta-analysis.
Marr, Ketevan; Maguet, Charlotte; Scarlett, Honor; Dray-Spira, Rosemary; Dubertret, Caroline; Gressier, Florence; Sutter-Dallay, Anne-Laure; Melchior, Maria; van der Waerden, Judith.
Afiliação
  • Marr K; Institut Pierre Louis d'Epidémiologie et de Santé Publique, Équipe de Recherche en Épidémiologie Sociale, Paris, France.
  • Maguet C; Institut Pierre Louis d'Epidémiologie et de Santé Publique, Équipe de Recherche en Épidémiologie Sociale, Paris, France.
  • Scarlett H; Institut Pierre Louis d'Epidémiologie et de Santé Publique, Équipe de Recherche en Épidémiologie Sociale, Paris, France.
  • Dray-Spira R; Institut Pierre Louis d'Epidémiologie et de Santé Publique, Équipe de Recherche en Épidémiologie Sociale, Paris, France.
  • Dubertret C; EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety, French National Health Insurance, Saint-Denis, France.
  • Gressier F; AP-HP, Groupe Hospital-Universitaire AP-HP Nord, DMU ESPRIT, Service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France.
  • Sutter-Dallay AL; Faculté de Médecine, Université de Paris, Paris, France.
  • Melchior M; CESP, Inserm UMR1178, Department of Psychiatry, Assistance Publique-Hôpitaux de Paris, Bicêtre University Hospital, Le Kremlin Bicêtre, France.
  • van der Waerden J; Inserm, Bordeaux Population Health Research Center, U1219, Bordeaux University, Bordeaux, France.
Acta Psychiatr Scand ; 2023 Dec 25.
Article em En | MEDLINE | ID: mdl-38145902
ABSTRACT

INTRODUCTION:

Depression is one of the most common co-morbidities during pregnancy; with severe symptoms, antidepressants are sometimes recommended. Social determinants are often linked with antidepressant use in the general population, and it is not known if this is the case for pregnant populations. Our objective was to determine if social determinants are associated with prenatal antidepressant intake via a systematic review and meta-analysis.

METHODS:

A systematic search of five databases was conducted to identify publications from inception to October 2022 that reported associations with prenatal antidepressant intake (use/continuation) and one or more social determinants education, race, immigration status, relationship, income, or employment. Eligible studies were included in random effects meta-analyses.

RESULTS:

A total of 23 articles describing 22 studies were included. Education was significantly and positively associated with prenatal antidepressant continuation and heterogeneity was moderate. (Odds ratio = 0.83; 95% CI, 0.78 to 0.89; p < 0.00001; I2 = 53%). Meta-analyses of antidepressant use and education, race, and relationship status, and antidepressant continuation and income were not significant with high levels of heterogeneity.

DISCUSSION:

While most social determinants in this review were not linked with prenatal antidepressant intake, lower maternal education level does seem to be associated with lower rates of prenatal antidepressant continuation.

CONCLUSIONS:

Education appears to be linked with prenatal antidepressant intake. The low number of included studies precludes conclusive evidence for other social determinants.
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Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Systematic_reviews Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Systematic_reviews Idioma: En Ano de publicação: 2023 Tipo de documento: Article