THE EFFECT OF ASCERTAINMENT BIAS IN EVALUATING GESTATIONAL ANTIDEPRESSANT EXPOSURE

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Gideon Koren

Keywords

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Abstract

Several administrative database studies have reported on a positive association between first trimester exposure to paroxetine and ventricular septal defects (VSD). Using multiple source data, we have shown that depressed women utilize significantly more health care resources, including ultrasound, echocardiogram and emergency room visits for their babies. Hence, there is much higher chance to identify VSD in their babies than among healthy controls. Moreover, paroxetine has been used more specifically than other SSRI for anxiety, further increasing the chance of ascertainment bias.

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References

1. Einarson TR, Einarson A. Newer antidepressants in pregnancy and rates of major malformations: a meta-analysis of prospective comparative studies. Pharmacoepidemiol Drug Saf 2005; 14: 823-827.
2. Berard A, Ramos E, Oraichi D, et al. Gestational exposure to paroxetine and cardiac malformations in infants: a nested case-control study. Birth Defects Res A Clin Mol Teratol 2006; 76: 335.
3. Wurst KE, Poole C, Ephross SA, Olshan AF. First trimester paroxetine use and the prevalence of congenital, specifically cardiac defects: a meta-analysis of epidemiological studies. Birth Defects Res A ClinMol Teratoil 2010; 88: 159-70.
4. Einarson A, Pistelli A, DeSantis M, Malm H, Paulus WD, Panchaud A, Kennedy D, Einarson TR, Koren G. Evaluation of the risk of congenital cardiovascular defects associated with use of paroxetine during pregnancy. Am J Psychiatry 2008; 165: 749-52.
5. Minkovitz CS, Strobino D, Scharfstein D, et al. Maternal depressive symptoms and children’s receipt of health care in the first 3 years of life. Pediatrics 2005; 115: 306-314.
6. Williams PR, Argent EH, Chalmers C. A study of an urban health centre: factors influencing contact with mothers and their babies. Child Care Health Dev 1981; 7: 255-266.
7. Tamblyn R, Lavoie G, Petrella L, Monette J. The use of prescription claims databases in pharmacoepidemiological research: the accuracy and comprehensiveness of the prescription claims database in Quebec. J Clin Epidemiol 1995; 48: 999-1009.
8. Levy AR, Mayo NE, Grimard G. Rates of transcervical and pertrochanteric hip fractures in the province of Quebec, Canada, 1981-1992. Am J Epidemiol 1995; 142: 428-436.
9. Lacasse AM, Rey E, Ferreira E, et al. Nausea and vomiting of pregnancy: are there multiethnic differences in the reporting and management? Pharmacoepidemiol Drug Saf 2005; 14: S203.
10. Roy E, Haley N, Leclerc P, et al. Mortality in a cohort of street youth in Montreal. JAMA 2004; 292: 569-574.
11. Bar-Oz B, Einarson T, Einarson A, Boskovic R, O’Brien L, Malm H, Berard A, Koren G. Paroxetine and congenital malformations: metaanalysis and consideration of potential confounding factors. Clin Ther 2007; 29: 918-26.
12. Einarson A. Influence of the media on women taking antidepressants during pregnancy. J Clin Psychiatry 2009; 70: 1313-4.
13. Roguin N, Du ZD, Barak M, Nasser N, Hershkowitz S, Milgram E. High prevalence of muscular ventricular septal defects in neonates. JACC 1995; 26: 1545-8.
14. Cohen LS, Altshuler LL, Harlow BL, et al. Relapse of major depression during pregnancy in women who maintain or discontinue antidepressant treatment. [ published correction appears in JAMA. 2006; 296: 170]. JAMA 2006; 295: 499-507.

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