Table 2.
Risk of late‐onset preeclampsia—overall and by severity—according to timing of SSRI exposure in pregnancy (n = 5745)
| Depressed Cohort | Total | N (%) with Outcome | Crude RR (95% CI) | Unweighted Adjusted RRa (95% CI) | Weighted Adjusted RRb (95% CI) |
|---|---|---|---|---|---|
| Preeclampsia, any severity | |||||
| Nonmedicated, GWs 0‐16 | 5154 | 186 (3.6) | Reference | Reference | |
| SSRI, GWs 0‐16 | 591 | 22 (3.7) | 1.03 (0.67‐1.59) | 0.96 (0.63‐1.46) | — |
| Nonmedicated, GWs 17‐28 | 5505 | 200 (3.6) | Reference | Reference | Reference |
| SSRI, GWs 17‐28 | 240 | 8 (3.3) | 0.92 (0.46‐1.84) | 0.92 (0.48‐1.79) | 0.66 (0.33‐1.28) |
| Nonmedicated, GWs 29‐34 | 5547 | 200 (3.6) | Reference | Reference | Reference |
| SSRIs, GWs 29‐34 | 198 | 8 (4.0) | 1.12 (0.56‐2.24) | 1.08 (0.57‐2.07) | 1.34 (0.61‐2.93) |
| Nonmedicated, GWs 0‐34 | 5093 | 184 (3.6) | Reference | Reference | |
| SSRIs, GWs 0‐34 | 652 | 24 (3.7) | 1.02 (0.67‐1.55) | 0.96 (0.64‐1.45) | — |
| Preeclampsia, mild | |||||
| Nonmedicated, GWs 0‐16 | 5092 | 124 (2.4) | Reference | Reference | |
| SSRI, GWs 0‐16 | 585 | 16 (2.7) | 1.12 (0.67‐1.88) | 1.05 (0.63‐1.75) | — |
| Nonmedicated, GWs 17‐28 | 5438 | 133 (2.5) | Reference | Reference | Reference |
| SSRI, GWs 17‐28 | 239 | 7 (2.9) | 1.20 (0.57‐2.53) | 1.22 (0.59‐2.54) | 0.76 (0.38‐1.53) |
| Nonmedicated, GWs 29‐34 | 5480 | 133 (2.4) | Reference | Reference | Reference |
| SSRI, GWs 29‐34 | 197 | 7 (3.6) | 1.46 (0.69‐3.09) | 1.49 (0.73‐3.04) | 1.56 (0.71‐3.44) |
| Nonmedicated, GWs 0‐34 | 5031 | 122 (2.4) | Reference | Reference | |
| SSRI, GWs 0‐34 | 646 | 18 (2.8) | 1.15 (0.71‐1.87) | 1.10 (0.67‐1.80) | — |
| Preeclampsia, severe | |||||
| Nonmedicated, GWs 0‐34 | 4959 | 50 (1.0) | Reference | Reference | |
| SSRI, GWs 0‐34 | 633 | 5 (0.8) | 0.78 (0.31‐1.96) | 0.72 (0.31‐1.68) | — |
Abbreviations: CI, confidence interval; GW, gestational week; RR, relative risk; SSRI, selective serotonin reuptake inhibitors.
Numbers of severe and mild late‐onset preeclampsia may not add up to total due to cases of unspecified late‐onset preeclampsia. Data are not shown because of low number of cases. Severe late‐onset preeclampsia could only be explored in relation to the exposure window GWs 0‐34 because of low statistical power.
Adjusted for maternal age, body mass index at conception, woman's socioeconomic status, educational level, parity, smoking status in pregnancy, weight gain, comedication with analgesics or other psychotropics, lifetime history of major depression, and average z‐score of depressive and anxiety symptoms at 2 time points in pregnancy.
Marginal structural model weighted with stabilized inverse probability of treatment weighting constructed at each time point using baseline covariates, time‐varying and time‐fixed confounding factors, and SSRI history treatment.