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Harms
Cohort study
Peripartum antidepressant use is associated with an increased risk of postpartum haemorrhage
  1. Jane B Ford1,
  2. Jonathan M Morris1,2
  1. 1Clinical and Population Perinatal Health Research, Kolling Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia;
  2. 2Department of Obstetrics and Gynaecology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
  1. Correspondence to: Associate Professor Jane Ford Clinical and Population Perinatal Health Research, C/- University Department of Obstetrics and Gynaecology, Building 52, Royal North Shore Hospital, St Leonards, NSW 2065, Australia; jane.ford{at}sydney.edu.au

https://doi.org/10.1136/eb-2013-101570

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    Commentary on: Palmsten K, Hernández-Díaz S, Huybrechts KF, et al. Use of antidepressants near delivery and risk of postpartum hemorrhage: cohort study of low income women in the United States. BMJ 2013;347:f4877.OpenUrlAbstract/FREE Full Text

    Context

    Increased incidence of postpartum haemorrhage (PPH) is reported in a number of high-resource settings since the 1990s. The increase appears unrelated to factors such as rising rates of caesarean sections or increasing maternal age.1 Recent studies have investigated the association between antidepressant use at different stages of pregnancy and PPH, with two studies demonstrating a 1.20-fold2 and 1.45-fold3 increased risk of bleeding at delivery, while another reported no association.4 Selective serotonin reuptake inhibitors (SSRIs) are increasingly prescribed and may impair platelet function by blocking serotonin uptake into platelets and impairing their homeostatic ability. Palmsten and colleagues aimed to assess the association between exposure to antidepressants—particularly SSRIs—at the time of delivery, …

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    Footnotes

    • Competing interests None.