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BACKGROUND: Few studies investigated longitudinal antidepressant exposure during pregnancy and included dosage in the assessment. METHODS: We conducted a nationwide, registry-linkage study in Norway using data on antidepressant prescription fills in pregnancies lasting ≥32 weeks in women with a delivery between 2009 and 2018 who had a depression/anxiety diagnosis and antidepressant fills prior to pregnancy. Information on antidepressant exposure by week (measured by filled prescriptions) and prescribed average daily dose was used in longitudinal k-means trajectory modelling for a 108-week time window from six months prior to pregnancy to one year after delivery. Factors associated with trajectory group membership were examined using multinomial logistic regression models. RESULTS: We included 8,460 pregnancies in 8,092 women. Four antidepressant fill trajectories were identified based on filled antidepressant prescriptions: two distinct discontinuing patterns, one at around the start of pregnancy (30.4%) and one around the end of pregnancy (33.8%); one continuing pattern (20.6%); and one interrupting pattern (15.2%). Using average usual daily dose, we identified low dose discontinuing (60.3%), medium dose reducing (20.6%) and high dose continuing (15.2%) patterns. The multinomial logistic regressions showed that the fill trajectory group membership was strongly associated with: antidepressant type and dose prior to pregnancy and co-medication prior to pregnancy, maternal age, marital status, parity, previous pregnancy loss, and pregnancy planning. CONCLUSION: Longitudinal trajectory modelling revealed distinct antidepressant fill and dosage patterns in the period around pregnancy. Knowledge about factors associated with utilization trajectories might be useful for health-care personnel counselling women about antidepressant use in pregnancy.

Objective: Quantitative studies examining the occurrence of childbirth‐related posttraumatic stress disorder (CB‐PTSD) following severe perineal rupture are lacking. The objective of this population‐based study was to investigate the prospective associations between the degree of perineal tear during childbirth and CB‐PTSD symptoms, when adjusting for known covariates (maternal age, years of school education, premature birth, and parity). We hypothesized that women with different degrees of perineal tear will differ regarding (1) the level of CB‐PTSD symptoms at 8 weeks and 2 years postpartum and (2) the rate of change in CB‐PTSD symptoms from 8 weeks to 2 years postpartum. Method: Secondary data analysis from the Akershus Birth Cohort, a large population‐based prospective cohort study using self‐report questionnaires and hospital record data. Results: The degree of perineal tear was significantly associated with CB‐PTSD symptoms at 8 weeks and 2 years postpartum. However, the degree of perineal tear was not significantly associated with the change in CB‐PTSD symptoms over time. Similar patterns were found for both total CB‐PTSD symptoms as well as for avoidance and intrusion symptoms only. Conclusion: Results seem to support a dose–response model, suggesting that the higher the severity of the perineal tear, the higher the posttraumatic morbidity. [ABSTRACT FROM AUTHOR]

Introduction Anxiety in women is highly prevalent during pregnancy and in the postnatal period. Anxiety disorders in mothers have been linked to adverse outcomes in their children's development. However, large-scale prospective studies on this issue, covering both the prenatal and postnatal period with follow-up periods beyond the first year of life are scarce. Method In this prospective cohort study, data gathered from 1336 Norwegian women and their children were used. Maternal anxiety symptoms were measured at gestation week 17-19 and 32, as well as 8 weeks postpartum using the Symptom Check List. Child development problems were assessed at 2 years postpartum using the Ages & Stages Questionnaire: Social-Emotional. Logistic regressions were conducted to examine the association between maternal prenatal, postnatal, and perinatal anxiety and the risk of social-emotional development problems in 2-year-old children. Results Of all women, 8.2% experienced prenatal anxiety, 4.0% had postnatal anxiety, and 4.4% reported perinatal anxiety (i.e., anxiety in both the prenatal and postnatal period). 5.6% of the 2-year-olds showed problems in their social-emotional behavior. Child development problems were associated with maternal prenatal anxiety (Odds Ratio [OR] = 2.48, 95% CI 1.55-4.92), postnatal anxiety (OR 3.32, 95% CI 1.43-7.74), and anxiety both in the prenatal and postnatal period (OR 3.98, 95% CI 1.85-8.56). Adjusted for confounders, maternal anxiety continued to be a significant predictor of adverse child social-emotional development (postnatal anxiety: OR 2.46, 95% CI 1.01-5.97; perinatal anxiety: OR 2.40, 95% CI 1.03-5.59). Discussion Maternal postnatal anxiety and anxiety both during and after pregnancy are unique substantial predictors for problems in a 2-year-old's social-emotional development, even when controlled for confounders., Author(s): Carolin Polte [sup.1] , Carolin Junge [sup.1] , Tilmann von Soest [sup.2] , Andreas Seidler [sup.1] , Malin Eberhard-Gran [sup.3] [sup.4] [sup.5] [sup.7] , Susan Garthus-Niegel [sup.3] [sup.6] Author [...]

Objectives This longitudinal population study aimed to investigate if maternal depression at different time points during the perinatal period impacts children's social-emotional development at 2 years of age. Methods Participants were women (n = 1235) who gave birth at Akershus University Hospital in Norway. Maternal depressive symptoms were assessed by using the Edinburgh Postnatal Depression Scale at pregnancy week 32 and at 8 weeks and 2 years postpartum, whereas children's social-emotional development at the age of 2 years was assessed by using the Ages and Stages Questionnaire: Social-Emotional. Bi- and multivariate logistic regression analyses were conducted to examine the linkage between maternal perinatal depression and children's early social-emotional development. Results Multivariate analyses showed that social-emotional problems in the child 2 years after birth were strongly associated with maternal depression at pregnancy week 32 (adjusted odds ratio (aOR) 3.4; 95 % CI 1.4-8.0), depression at 8 weeks postpartum (aOR 3.8; 95 % CI 1.7-8.6), and with depression at both time points (aOR 3.7; 95 % CI 1.5-10.1). Conclusion Findings indicate pre- and postnatal depression each bears an independent, adverse impact on children's social-emotional development., Author(s): Carolin Junge [sup.1] [sup.2] , Susan Garthus-Niegel [sup.1] [sup.2] [sup.3] , Kari Slinning [sup.4] [sup.5] , Carolin Polte [sup.2] , Tone Breines Simonsen [sup.6] [sup.7] , Malin Eberhard-Gran [sup.1] [...]