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Antidepressants Given Near Delivery Associated with More Postpartum Hemorrhage — Physician’s First Watch

Medical News |
August 23, 2013

Antidepressants Given Near Delivery Associated with More Postpartum Hemorrhage

By Joe Elia

Women exposed to antidepressants near the time of delivery show an increased risk for postpartum hemorrhage, according to a BMJ study.

Researchers analyzed Medicaid data on some 100,000 women with a diagnosis of mood or anxiety disorder. They used pharmacy dispensing data to characterize exposure, with "current exposure" defined as having a supply of antidepressant medicine on hand that overlapped with the delivery date.

Compared with nonexposed women (i.e., those having no drug supply within 5 months of the delivery date), those with current exposure showed a roughly 1.5-fold increased risk for postpartum hemorrhage. The authors calculate a number need to harm of 80 for patients on serotonin reuptake inhibitors and 97 for nonserotonin reuptake inhibitors.

They speculate that the effect could be partly explained by the effect of blocking serotonin reuptake in platelets, but the association with nonserotonin inhibiting drugs is "unexpected and should be confirmed."

Reader Comments (1)

Mark Gary Blumenthal, MD, MPH Physician, Family Medicine/General Practice

I appreciate your publishing that there’s a greater number needed to harm for SSRIs than for postpartum hemorrhage. This is half of the 'First, do no harm' equation.

However, it might be also valuable quantify and publish the morbidity and mortality rates, along with the numbers needed to harm, for postpartum hemorrhage AND for Postpartum Major Depressive Disorder.

While postpartum hemorrhage can and does harm, PPMD can and does harm both mother and baby, and carries a highly significant mortality rate.

Thank you!

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