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A population-based ...
A population-based study of concurrent prescriptions of opioid analgesic and selective serotonin reuptake inhibitor medications during pregnancy and risk for adverse birth outcomes
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- Sujan, Ayesha C. (author)
- Department of Psychological & Brain Sciences, Indiana University-Bloomington, Bloomington, IN, USA
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- Rickert, Martin E. (author)
- Department of Psychological & Brain Sciences, Indiana University-Bloomington, Bloomington, IN, USA
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- Quinn, Patrick D. (author)
- Department of Applied Health Science, School of Public Health, Indiana University-Bloomington, Bloomington, IN, USA
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- Ludema, Christina (author)
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University-Bloomington, Bloomington, IN, USA
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- Wiggs, Kelsey K. (author)
- Department of Psychological & Brain Sciences, Indiana University-Bloomington, Bloomington, IN, USA
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- Larsson, Henrik, 1975- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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- Lichtenstein, Paul (author)
- Karolinska Institutet
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- Almqvist, Catarina (author)
- Karolinska Institutet
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- Öberg, Anna Sara (author)
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology, T.H. Chan School of Public Health, Harvard, Boston, MA, USA
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- D'Onofrio, Brian M. (author)
- Karolinska Institutet
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(creator_code:org_t)
- 2020-12-22
- 2021
- English.
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In: Paediatric and Perinatal Epidemiology. - : Blackwell Science Ltd.. - 0269-5022 .- 1365-3016. ; 35:2, s. 184-193
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- BACKGROUND: Pregnant women with painful conditions often have mental health problems, including depression and anxiety. Co-morbid conditions may cause pregnant women to use multiple medications, although safety of such practice is poorly understood.OBJECTIVES: We investigated the influence of combined prescriptions of opioid analgesics and selective serotonin reuptake inhibitors (SSRIs) during pregnancy on two adverse birth outcomes.METHODS: We analysed Swedish population-based births (n = 688 914) between 2007 and 2013. Using national registers, we obtained data on filled medication prescriptions, birth outcomes, and a wide range of parental characteristics. We estimated preterm birth and small-for-gestational-age risk following independent or combined prescriptions of the two medications compared with no filled prescriptions for either medication. We adjusted for confounders using inverse probability of treatment weights.RESULTS: After adjusting for confounders, preterm birth risk was higher among women with opioid analgesic prescriptions only (5.9%; risk ratio [RR] 1.27, 95% confidence interval [CI] 1.22, 1.33), SSRIs only (6.2%; RR 1.34, 95% CI 1.27, 1.42), and both medications (7.8%; RR 1.70, 95% CI 1.47, 1.96) compared with unexposed women (4.6%). The interaction between the medications on preterm birth was small (risk difference [RD] 0.4%, 95% CI -0.8%, 1.6%); relative excess risk due to interaction [RERI] 0.09, 95% CI -0.17, 0.34; RR 1.00, 95% CI 0.85, 1.17). For small for gestational age, risk was approximately 2% across all groups, and there was no interaction between the medications (RD 0.3%, 95% CI -0.4%, 1.1%); RERI 0.15, 95% CI -0.16, 0.47; RR 1.15, 95% CI 0.87, 1.52).CONCLUSIONS: Compared with unexposed pregnancies, those with either medication alone had a small increased risk for preterm birth but no increased risk for small for gestational age. The magnitude of associations with combined exposure to both medications were not greater than the sum of the associations with each medication considered individually.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)
Keyword
- Antidepressant drugs
- opioid analgesic
- polypharmacy
- prenatal care
- preterm birth
- small-for-gestational-age infant
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Sujan, Ayesha C.
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Rickert, Martin ...
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Quinn, Patrick D ...
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Ludema, Christin ...
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Wiggs, Kelsey K.
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Larsson, Henrik, ...
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Lichtenstein, Pa ...
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Almqvist, Catari ...
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Öberg, Anna Sara
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D'Onofrio, Brian ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Obstetrics Gynae ...
- Articles in the publication
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Paediatric and P ...
- By the university
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Örebro University
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Karolinska Institutet