Women who use antidepressants during pregnancy are often unnecessarily concerned about the possible dangers posed to their unborn children. They may even stop using their medication without consulting their doctor. Researchers, policy makers, doctors and pharmacists must therefore pay more attention to translating research results that are often difficult to interpret for patients and caregivers. That is the conclusion of Doctoral Candidate Adrienne Einarson’s dissertation on 8 April. The 69 year-old Einarson is considered to be an expert in the field of the use of medication during pregnancy.
Interviews that Einarson conducted with 96 women who used antidepressants during pregnancy showed that many women are concerned due to negative information provided by physicians, the media and their family and friends. Negative research results regarding the use of antidepressants during pregnancy are more likely to be reported by the media than research that does not uncover possible risks. Moreover, it is not always possible or desirable to stop using antidepressants. In the most serious cases, this could even lead to an increased risk of suicide.
Einarson studied the risks of the use of antidepressants during pregnancy by combining previous research results and by collecting new data from the Motherisk programme that she helped set up in Canada. This databank contains data on almost 1,250 women who used antidepressants during their pregnancy. This research shows that the use of antidepressants during pregnancy poses only a slightly increased risk in a very small number of cases, and should be balanced against the potential benefits
Complex epidemiological research
“The difficulty is to differentiate between a risk due to the use of antidepressants and the risk posed by the underlying disease, depression”, explains co-promotor Dr. Rob Heerdink from Utrecht University. “This means that doctors must rely on complex epidemiological research, although they may not always have the specialist knowledge necessary to interpret it.”
Undesired side effects
Einarson therefore concludes that more attention must be paid to translating research results that are difficult to interpret; first from the researchers to the physicians and pharmacists, and then from them to the pregnant woman. “The clinical significance of the research results must be unambiguous, so that they do not lead to undesired side effects such as stopping essential therapy”, emphasises Einarson.
Einarson began her career as a nurse before helping to set up the Motherisk programme in Canada, an information system for pregnant women with questions about the use of pharmaceuticals. Since then, she has published more than 200 scientific articles and is considered one of the world’s leading experts in the field. After retiring, she decided to go ahead and earn her PhD. Researchers at Utrecht University have worked with her before, and she has supervised students from Utrecht during their internships in Toronto.
'Antidepressant use in pregnancy: knowledge transfer and translation of findings’
Pomotor: Prof. Toine Egberts, co-promotor Dr. Rob Heerdink.
The research was funded in part by the Canadian government.