One cohort study found that rates of mental health care utilization dropped during pregnancy in Norwegian women with depression and/or anxiety, even when they continued to use antidepressant treatment during pregnancy. Furthermore, among those who discontinued medication use during pregnancy and resumed after delivery, there was a marked increase in mental health care use during their postpartum year.1 These findings were published online ahead of print in the Journal of Affective Disorders.1
Researchers conducted a registry-linkage cohort study of pregnancies among women who had an outpatient visit for depression and/or anxiety and filled their antidepressant prescription before confirming their pregnancy. Data was obtained using four national registries in Norway from 2009-2018. The cohort included 8460 pregnancies within 8062 women who had depression and/or anxiety.1
Nearly 80% of the cohort discontinued use of prescribed antidepressant treatment in early or late pregnancy. The authors also observed a decrease in consultations with general practitioners (GPs) for prescription renewal, as well as a decrease in consultations with psychiatric specialists and psychologists for psychotherapy and follow-up. The latter 2 trends were also observed in women who continued to follow their medication regime, suggesting a general downtrend in utilization of psychotherapy during pregnancy.1
Of those who ceased antidepressant treatment during pregnancy, approximately one-third progressively resumed taking their medications following delivery. Consultation rates for depression and/or anxiety at outpatient clinics and public-contracted psychiatrists also increased during the postpartum year. These 2 trends together hint at a “Potential re-occurrence or relapse of depression/anxiety after antidepressant continuation.”1
“To safeguard maternal mental health, as well as child and family well-being, it is…crucial to establish a systematic cooperation among primary-level and between-level health professionals, so that women with depression/anxiety with different antidepressant treatment preferences are adequately followed-up and treated,” Nhung T.H. Trinh, et al observed in the Journal of Affective Disorders.1
Reference:
1. Trinh NTH, Nordeng HME, Bandoli G, et al. Antidepressant and mental health care utilization in pregnant women with depression and/or anxiety An interrupted time-series analysis. J Affect Disord. 2022;308:458-465. doi:10.1016/j.jad.2022.04.101