Gestational weight gain and postpartum weight retention: What is the role of perinatal antidepressant use?

BACKGROUND

Little is known about the association between perinatal antidepressant use and gestational weight gain (GWG) and postpartum weight retention (PPWR).

METHODS

We used data from the Norwegian Mother, Father and Child Cohort Study (MoBa), linked to the Medical Birth Registry of Norway (MBRN) and the Norwegian Prescribed Drug Registry (LMR). We included singleton, live birth pregnancies with pre-pregnancy depression/anxiety. Prenatal and perinatal antidepressant use trajectories were constructed using longitudinal k-means clustering. GWG and PPWR at 6/18 months postpartum were calculated using self-reported data. We estimated weighted relative risks (wRR) and 95 % confidence intervals (CI) using modified Poisson regression with robust variance estimators and overlap weights. For a sub-population with available genetics data, we used polygenic risk scores (PRSs) to partially account for confounding by genetic component.

RESULTS

Among 3365 pregnancies included, we observed six prenatal and perinatal antidepressant use trajectories: non-users, pre-pregnancy discontinuers, early pregnancy discontinuers, late pregnancy discontinuers, continuers, and post-pregnancy initiators. Pre-pregnancy discontinuers had increased risk of inadequate GWG compared to non-users (wRR 1.34, 95 % CI 1.03-1.73). Early pregnancy discontinuers (wRR 0.89, 95 % CI 0.78-1.02), late pregnancy discontinuers (wRR 0.88, 95 % CI 0.76-1.01), and continuers (wRR 0.86, 95 % CI 0.71-1.05) had a borderline decreased risk of excessive PPWR at 6 months postpartum compared to non-users. We observed no other associations between antidepressant use trajectories and GWG or PPWR.

CONCLUSION

These results enhance knowledge on weight-related safety concerns of antidepressant use in the prenatal and perinatal period, specifically regarding GWG and PPWR.