Study Links Antidepressant Use During Pregnancy to Gestational Diabetes

A new Canadian-based study has found a link between antidepressant use during pregnancy and an increased risk of developing gestational diabetes mellitus (GDM).

Results of the study, which analyzed more 200,000 pregnancies, found that use of antidepressants, specifically venlafaxine and amitriptyline were associated with an increased risk of GDM.

To assess a potential association between antidepressant classes, types, and duration of use during pregnancy and the risk of GDM, investigators performed a nested case-control study using the Quebec Pregnancy Cohort (QPC) database. Using data from 1998 through 2015, investigators identified a total of 237,172 pregnancies from the database that met the study’s inclusion criteria.

For inclusion in the study, all women must have been continuously covered by the public prescription drug plan for at least 6 months prior and during pregnancy, women could have no presence of type 1 or type 2 diabetes from 6 months prior and up to week 20 of the pregnancy, and women with a history of GDM were also excluded. Only singleton births were included in the current analysis.

Of the 237,172 pregnancies included, investigators identified 20,905(8.8%) cases of GDM—the remaining 209,050 served as matched controls. Upon analyses, 1152(5.5%) of the 20,905 women were exposed to antidepressants. Investigators noted women with GDM were more likely to be older urban residents and to benefit from social assistance.

Performing confounder-adjusted analyses, investigators the finding that antidepressant use was associated with an increased risk of GDM was still present(aOR 1.19, 95% CI, 1.08 to 1.30). Investigators also noted venlafaxine(aOR 1.27, 95%CI 1.09 to 1.49) and amitriptyline(aOR 1.52, 95%CI 1.25 to 1.84) were also associated with an increased risk of GDM.

Additionally, the risk increased as duration of antidepressant use increased, specifically for serotonin norepinephrine reuptake inhibitors, trycilic antidepressants, and combined use of 2 classes. Investigators did not observe any statistically significant associations for selective serotonin reuptake inhibitors.

"The treatment of depression is a major concern and is challenging because depression is prevalent before and during pregnancy, and untreated depression can lead to relapse during pregnancy and in the postpartum period” investigators wrote.

The study, “Antidepressant use during pregnancy and the risk of gestational diabetes mellitus: a nested case—control study,” was published in BMJ Open.