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064 Social determinants of antidepressant continuation during pregnancy in the USA: findings from the ABCD cohort study
  1. Marc Dupuis1,
  2. Kristie Rebecca Weir1,2,
  3. Renata Vidonscky lüthold1,
  4. Alice Panchaud1,3,
  5. Stéphanie Baggio1,4
  1. 1Institute of Primary Health Care, University of Bern, Bern, Switzerland
  2. 2Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
  3. 3Service of Pharmacy, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
  4. 4Population Health Laboratory, University of Fribourg, Fribourg, Switzerland

Abstract

Introduction Patients and healthcare professionals frequently overestimate the risks of using antidepressants during pregnancy. Consequently, shared decision on continuing medication remains rare. Upon pregnancy approximately half of people stop taking an anti-depressant medication. Discontinuing antidepressants due to pregnancy increases risks of postnatal relapses. Factors like socioeconomic status, education, and planned pregnancies play a role in whether women continue their medication. Social and economic factors can thus worsen disparities in maternal and child health. Our aim was to identify the sociodemographic factors associated with antidepressant continuation after awareness of pregnancy.

Methods We used data from the Adolescent Brain Cognitive Development (ABCD) study that captures parents’ medication during their pregnancy. We identified people who used antidepressants before awareness of their pregnancy. We calculated crude and adjusted associations between sociodemographic factors and continuation of antidepressant medication after awareness of pregnancy. Our model included age, education, ethnicity, first language, household income, living with a partner, having planned the pregnancy, pregnancy duration and smoking during pregnancy.

Result In total, 199 people continued antidepressants and 100 discontinued. The logistic regressions resulted in only one significant factor, the first language. Native English speakers were more likely to continue medication than other parents (adjusted OR = 13.93, 95% CI = [2.19; 273.37], p = .018).

Discussion Language differences seem to play a role in the decision to continue or discontinue treatment, leading to health inequities among non-native English speakers in the USA. The association between first language and antidepressant continuation may reflect differences in access to up-to-date information on medication and economic differences between natives and migrants (though controlling for household income).

Conclusion The present finding should be taken into account in order to reinforce information about the limited risks of antidepressants among patients with migrant backgrounds, in the USA and in other countries.

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