Journal article
Selective Serotonin Reuptake Inhibitor Use in Pregnancy and Protective Mechanisms in Preeclampsia
Reproductive sciences (Thousand Oaks, Calif.), Vol.30(2), pp.701-712
02/2023
DOI: 10.1007/s43032-022-01065-z
PMCID: PMC9944568
PMID: 35984571
Abstract
Depression and preeclampsia share risk factors and are bi-directionally associated with increased risk for each other. Despite epidemiological evidence linking selective serotonin reuptake inhibitors (SSRIs) in pregnancy to preeclampsia, serotonin (5-HT) and vasopressin (AVP) secretion mechanisms suggest that SSRIs may attenuate preeclampsia risk. However, there is a need to clarify the relationship between SSRIs and preeclampsia in humans to determine therapeutic potential. This retrospective cohort study included clinical data from 9558 SSRI-untreated and 9046 SSRI-treated pregnancies. In a subcohort of 233 pregnancies, early pregnancy (< 20 weeks) maternal plasma copeptin, an inert and stable AVP prosegment secreted 1:1 with AVP, was measured by enzyme-linked immunosorbent assay. Diagnoses and depression symptoms (Patient Health Questionnaire-9 [PHQ-9]) were identified via medical records review. Descriptive, univariate, and multivariate regression analyses were conducted (α = 0.05). SSRI use was associated with decreased preeclampsia after controlling for clinical confounders (depression severity, chronic hypertension, diabetes, body mass index, age) (OR = 0.9 [0.7–1.0], p = 0.05). Moderate-to-severe depression symptoms were associated with significantly higher copeptin secretion than mild-to-no depression symptoms (240 ± 29 vs. 142 ± 10 ng/mL, p < 0.001). SSRIs significantly attenuated first trimester plasma copeptin (78 ± 22 users vs. 240 ± 29 ng/ml non-users, p < 0.001). In preeclampsia, SSRI treatment was associated with significantly lower copeptin levels (657 ± 164 vs. 175 ± 134 ng/mL, p = 0.04). Interaction between SSRI treatment and preeclampsia was also significant (p = 0.04). SSRIs may modulate preeclampsia risk and mechanisms, although further studies are needed to investigate the relationships between 5-HT and AVP in depression and preeclampsia.
Details
- Title: Subtitle
- Selective Serotonin Reuptake Inhibitor Use in Pregnancy and Protective Mechanisms in Preeclampsia
- Creators
- Julie A Vignato - University of IowaS Banu GumusogluHeather A DavisSabrina M ScrogginsWendy S HamiltonDebra S BrandtGary L PierceBoyd A KnospDonna A SantillanMark K Santillan
- Resource Type
- Journal article
- Publication Details
- Reproductive sciences (Thousand Oaks, Calif.), Vol.30(2), pp.701-712
- DOI
- 10.1007/s43032-022-01065-z
- PMID
- 35984571
- PMCID
- PMC9944568
- NLM abbreviation
- Reprod Sci
- eISSN
- 1933-7205
- Grant note
- DOI: 10.13039/100000056, name: National Institute of Nursing Research, award: T32NR11147; DOI: 10.13039/100000071, name: National Institute of Child Health and Human Development, award: R01HD089940, P50HD103556; DOI: 10.13039/100000025, name: National Institute of Mental Health, award: T32MH01911328; DOI: 10.13039/100000968, name: American Heart Association, award: 18SCG34350001, 15 SFRN 23730000
- Language
- English
- Electronic publication date
- 08/19/2022
- Date published
- 02/2023
- Academic Unit
- Iowa Neuroscience Institute; Nursing; Obstetrics and Gynecology; Medicine Administration; Health, Sport, and Human Physiology ; Internal Medicine
- Record Identifier
- 9984296304102771
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