Table 2. Characteristics of Control Mothers Exposed and Unexposed to Antidepressants Before and During Pregnancy in the National Birth Defects Prevention Study From 1997 to 2011.
| Characteristica | No. (%) | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Antidepressant use in mothers in the NBDPS | Among women with any antidepressant use during early pregnancy, characteristics by specific antidepressante | |||||||||
| No use before or during pregnancy (n = 10 886)b | Use solely outside of early pregnancy (n = 125)c | Any antidepressant use during early pregnancy (n = 467)d | Sertraline (n = 129) | Fluoxetine (n = 81) | Paroxetine (n = 43) | Citalopram (n = 39) | Escitalopram (n = 35) | Venlafaxine (n = 21) | Bupropion (n = 45) | |
| Age, y | ||||||||||
| <20 | 1094 (10.1) | 10 (8.0) | 22 (4.7) | 8 (6.2) | 4 (4.9) | 1 (2.3) | 2 (5.1) | 0 (0) | 1 (4.8) | 0 (0) |
| 20-24 | 2479 (22.8) | 23 (18.4) | 83 (17.8) | 26 (20.2) | 11 (13.6) | 7 (16.3) | 7 (18.0) | 5 (14.3) | 2 (9.5) | 13 (28.9) |
| 25-29 | 3009 (27.6) | 35 (28.0) | 132 (28.3) | 31 (24.0) | 27 (33.3) | 17 (39.5) | 8 (20.5) | 7 (20.0) | 7 (33.3) | 13 (28.9) |
| 30-34 | 2784 (25.6) | 40 (32.0) | 151 (32.3) | 43 (33.3) | 26 (32.1) | 13 (30.2) | 16 (41.0) | 16 (45.7) | 4 (19.1) | 13 (28.9) |
| 35-39 | 1267 (11.6) | 16 (12.8) | 66 (14.1) | 18 (14.0) | 10 (12.4) | 4 (9.3) | 5 (12.8) | 6 (17.1) | 7 (33.3) | 5 (11.1) |
| ≥40 | 253 (2.3) | 1 (0.8) | 13 (2.8) | 3 (2.3) | 3 (3.7) | 1 (2.3) | 1 (2.6) | 1 (2.9) | 0 (0) | 1 (2.2) |
| Race/ethnicityf | ||||||||||
| Non-Hispanic | ||||||||||
| White | 6178 (56.8) | 97 (77.6) | 396 (84.8) | 107 (83.0) | 67 (82.7) | 35 (81.4) | 34 (87.2) | 32 (91.4) | 17 (81.0) | 42 (93.3) |
| Black | 1224 (11.3) | 6 (4.8) | 19 (4.1) | 7 (5.4) | 3 (3.7) | 2 (4.7) | 2 (5.1) | 0 (0) | 1 (4.8) | 0 (0.0) |
| Hispanic | 2761 (25.4) | 12 (9.6) | 31 (6.6) | 10 (7.8) | 7 (8.6) | 4 (9.3) | 0 (0) | 1 (2.9) | 2 (9.5) | 3 (6.7) |
| Other | 717 (6.6) | 10 (8.0) | 21 (4.5) | 5 (3.9) | 4 (4.9) | 2 (4.7) | 3 (7.7) | 2 (5.7) | 1 (4.8) | 0 (0.0) |
| Education, y | ||||||||||
| <12 | 1818 (16.9) | 21 (17.1) | 43 (9.3) | 13 (10.2) | 9 (11.3) | 7 (16.3) | 3 (7.7) | 0 (0) | 1 (4.8) | 2 (4.4) |
| 12 | 2569 (23.9) | 26 (21.1) | 91 (19.7) | 30 (23.6) | 21 (26.3) | 10 (23.3) | 3 (7.7) | 6 (17.1) | 1 (4.8) | 7 (15.6) |
| ≥12 | 6376 (59.2) | 76 (61.8) | 328 (71.0) | 84 (66.1) | 50 (62.5) | 26 (60.5) | 33 (84.6) | 29 (82.9) | 19 (90.5) | 36 (80.0) |
| Prepregnancy BMI | ||||||||||
| <18.5 | 563 (5.4) | 9 (7.3) | 14 (3.0) | 2 (1.6) | 2 (2.5) | 3 (7.0) | 2 (5.1) | 0 (0) | 1 (4.8) | 2 (4.6) |
| 18.5-24.9 | 5606 (53.9) | 60 (48.4) | 251 (54.0) | 73 (56.6) | 48 (60.0) | 25 (58.1) | 19 (48.7) | 15 (42.9) | 8 (38.1) | 27 (61.4) |
| 25.0-29.9 | 2375 (22.8) | 30 (24.2) | 95 (20.4) | 24 (18.6) | 15 (18.8) | 4 (9.3) | 11 (28.2) | 9 (25.7) | 5 (23.8) | 7 (15.9) |
| ≥30.0 | 1866 (17.9) | 25 (20.2) | 105 (22.6) | 30 (23.3) | 15 (18.8) | 11 (25.6) | 7 (18.0) | 11 (31.4) | 7 (33.3) | 8 (18.2) |
| Early pregnancy cigarette smokingg | ||||||||||
| Yes | 1866 (17.3) | 37 (29.8) | 133 (28.7) | 37 (29.1) | 19 (23.8) | 17 (39.5) | 11 (28.2) | 9 (25.7) | 4 (19.1) | 16 (35.6) |
| No | 8936 (82.7) | 87 (70.2) | 330 (71.3) | 90 (70.9) | 61 (76.3) | 26 (60.5) | 28 (71.8) | 26 (74.3) | 17 (80.9) | 29 (64.4) |
| Early pregnancy alcohol useg | ||||||||||
| Yes | 3935 (36.5) | 64 (51.6) | 233 (50.4) | 58 (45.7) | 46 (57.5) | 22 (51.2) | 19 (48.7) | 21 (61.8) | 11 (52.4) | 17 (37.8) |
| No | 6833 (63.5) | 60 (48.4) | 229 (49.6) | 69 (54.3) | 34 (42.5) | 21 (48.8) | 20 (51.3) | 13 (38.2) | 10 (47.6) | 28 (62.2) |
| Folic acid useh | ||||||||||
| Yes | 5712 (52.5) | 72 (57.6) | 281 (60.2) | 77 (59.7) | 49 (60.5) | 18 (41.9) | 26 (66.7) | 26 (74.3) | 11 (52.4) | 28 (62.2) |
| No | 5174 (47.5) | 53 (42.4) | 186 (39.8) | 52 (40.3) | 32 (39.5) | 25 (58.1) | 13 (33.3) | 9 (25.7) | 10 (47.6) | 17 (37.8) |
| Pregnancy intention | ||||||||||
| Wanted to be pregnant then | 5298 (59.6) | 51 (51.5) | 200 (55.7) | 64 (62.8) | 39 (60.9) | 14 (40.0) | 17 (58.6) | 11 (42.3) | 8 (53.3) | 17 (51.5) |
| Wanted to wait until later | 1806 (20.3) | 25 (25.3) | 76 (21.2) | 18 (17.7) | 14 (21.9) | 12 (34.3) | 8 (27.6) | 7 (26.9) | 2 (13.3) | 5 (15.2) |
| Did not want to be pregnant at all | 1011 (11.4) | 12 (12.1) | 41 (11.4) | 10 (9.8) | 6 (9.4) | 5 (14.3) | 1 (3.5) | 2 (7.7) | 3 (20.0) | 6 (18.2) |
| Did not care | 777 (8.7) | 11 (11.1) | 42 (11.7) | 10 (9.8) | 5 (7.8) | 4 (11.4) | 3 (10.3) | 6 (23.1) | 2 (13.3) | 5 (15.2) |
| Previous live births | ||||||||||
| ≥1 | 6525 (60.0) | 85 (68.0) | 309 (66.2) | 84 (65.1) | 51 (63.0) | 32 (74.4) | 28 (71.8) | 22 (62.9) | 13 (61.9) | 34 (75.6) |
| None | 4357 (40.0) | 40 (32.0) | 158 (33.8) | 45 (34.9) | 30 (37.0) | 11 (25.6) | 11 (28.2) | 13 (37.1) | 8 (38.1) | 11 (24.4) |
| Plurality | ||||||||||
| Multiple | 265 (2.4) | 3 (2.4) | 10 (2.1) | 3 (2.3) | 0 (0) | 0 (0) | 0 (0) | 1 (2.9) | 2 (9.5) | 2 (4.4) |
| Singleton | 10 617 (97.6) | 122 (97.6) | 457 (97.9) | 126 (97.7) | 81 (100) | 43 (100) | 39 (100) | 34 (97.1) | 19 (90.5) | 43 (95.6) |
| Study sitei | ||||||||||
| Arkansas | 1348 (12.4) | 24 (19.2) | 66 (14.1) | 20 (15.5) | 9 (11.1) | 3 (7.0) | 4 (10.3) | 6 (17.1) | 3 (14.3) | 7 (15.6) |
| California | 1196 (11.0) | 4 (3.2) | 32 (6.9) | 8 (6.2) | 8 (9.9) | 3 (7.0) | 1 (2.6) | 2 (5.7) | 1 (4.8) | 3 (6.7) |
| Georgia | 1181 (10.9) | 12 (9.6) | 35 (7.5) | 10 (7.8) | 10 (12.4) | 1 (2.3) | 4 (10.3) | 3 (8.6) | 1 (4.8) | 1 (2.2) |
| Iowa | 1181 (10.9) | 19 (15.2) | 73 (15.6) | 19 (14.7) | 10 (12.4) | 9 (20.9) | 5 (12.8) | 8 (22.9) | 2 (9.5) | 8 (17.8) |
| Massachusetts | 1288 (11.8) | 20 (16.0) | 69 (14.8) | 16 (12.4) | 14 (17.3) | 6 (14.0) | 8 (20.5) | 3 (8.6) | 4 (19.1) | 5 (11.1) |
| New Jersey | 563 (5.2) | 0 (0.0) | 9 (1.9) | 3 (2.3) | 1 (1.2) | 3 (7.0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
| New York | 914 (8.4) | 8 (6.4) | 35 (7.5) | 11 (8.5) | 5 (6.2) | 5 (11.6) | 2 (5.1) | 1 (2.9) | 1 (4.8) | 4 (8.9) |
| North Carolina | 903 (8.3) | 14 (11.2) | 47 (10.1) | 11 (8.5) | 6 (7.4) | 5 (11.6) | 3 (7.7) | 6 (17.1) | 4 (19.1) | 6 (13.3) |
| Texas | 1300 (11.9) | 11 (8.8) | 25 (5.4) | 11 (8.5) | 3 (3.7) | 3 (7.0) | 1 (2.6) | 1 (2.9) | 0 (0) | 3 (6.7) |
| Utah | 1012 (9.3) | 13 (10.4) | 76 (16.3) | 20 (15.5) | 15 (18.5) | 5 (11.6) | 11 (28.2) | 5 (14.3) | 5 (23.8) | 8 (17.8) |
Abbreviations: BMI, body mass index (calculated as weight in kilograms divided by height in meters squared); NBDPS, National Birth Defects Prevention Study.
Women with missing data on maternal characteristics were excluded from the analysis. There were less than 5% missing data for all maternal characteristics, with the exception of pregnancy intention (18.4%).
No antidepressant use in the 3 months before conception through the end of pregnancy.
Antidepressant use 2 or 3 months before conception or during the fourth to ninth months of pregnancy but no antidepressant use in early pregnancy (1 month before conception through the third month of pregnancy). This may include monotherapy or polytherapy antidepressant use within this period.
Any antidepressant use regardless of individual medication or medication class in early pregnancy (1 month before conception through the third month of pregnancy), including less common medications. This may include monotherapy or polytherapy antidepressant use within this period. χ2 Tests were run for each characteristic to compare (1) any antidepressant use in early pregnancy vs no antidepressant use in the 3 months before conception to the end of pregnancy and (2) any antidepressant use in early pregnancy vs any antidepressant use only outside of early pregnancy. For set 1, the findings from the χ2 test rejected the null of no difference between groups for age, race/ethnicity, education, prepregnancy BMI, early pregnancy smoking and alcohol use, folic acid use, previous live births, and study site. For set 2, the findings from the χ2 tests rejected the null of no difference between groups for education.
Specific antidepressant monotherapy medication use in the month before conception through the third month of pregnancy when there was 0.2% or greater prevalence among control mothers.
During the interview, mothers were asked to self-report their own racial/ethnic status as there may be racial/ethnic differences in risk factors for specific birth defects. Racial/ethnic groups were further collapsed during analysis because of small sample sizes for some racial/ethnic groups.
In the month before conception through the third month of pregnancy.
In the month before conception through the first month of pregnancy.
Statewide data collection occurred in Arkansas, Iowa, New Jersey, and Utah; other sites included selected geographic regions within the state. Included years in each state were: Arkansas (1998-2011), California (1997-2011), Georgia (1997-2011), Iowa (1997-2011), Massachusetts (1997-2011), New Jersey (1998-2003), New York (1997-2002 and 2004-2011), North Carolina (2003-2011), Texas (1997-2007 and 2008-2011), and Utah (2003-2011).