Comparison of the groups treated with mirtazapine and selective serotonine reuptake inhibitors with respect to birth outcomes and severity of psychiatric disorder

Figures & data

Table 1. Diagnosis of patient groups.

	SSRI exposed (N = 40)	Mirtazapine exposed (N = 16)	SSRI-mirtazapine exposed (N = 18)	Psychiatric diagnosis unmedicated (N = 23)
Depressive disorder (N = 23)	8	5	5	5
Depressive disorder with anxious distress (N = 16)	8	3	4	1
Panic disorder (N = 21)	8	5	3	5
Obsessive compulsive disorder (N = 9)	3	0	1	5
Generalised anxiety disorder (N = 8)	0	1	1	6
Adjustment disorder (N = 3)	3	0	0	0
Generalised anxiety and depressive disorder comorbidity (N = 3)	2	0	0	1
Obsessive compulsive disorder and depressive disorder comorbidity (N = 5)	2	1	2	0
Generalised anxiety disorder and obsessive compulsive disorder comorbidity (N = 1)	1	0	0	0
Panic disorder and depressive disorder comorbidity (N = 8)	5	1	2	0

Table 2. Comparison of the sociodemographic properties of the groups.

	SSRI exposed (N = 40)	Mirtazapine exposed (N = 16)	SSRI-mirtazapine exposed (N = 18)	Psychiatric diagnosis unmedicated (N = 23)	Healthy Control (N = 23)	df	χ^2	p Chi Square/ Kruskall Wallis
Age	32.52 ± 4.87	34.87 ± 5.22	32.22 ± 4.13	33.04 ± 3.05	30.73 ± 3.88	4	9.20	0.056
Education	8.85 ± 4.17	7.31 ± 4.25	9 ± 3.91	8.21 ± 4.64	9.65 ± 4.78	4	3.08	0.544
Smoking (Yes/No)	%43/%57	%43/%57	%42/%58	%19/%81	%21/%79	4	5.51	0.231
Cigarette per day	3.12 ± 6.22	3.56 ± 5.37	4.29 ± 6.62	1.38 ± 3.54	0.73 ± 2.15	4	6.87	0.143

Table 3. Comparison of properties of illness of the groups.

	SSRI exposed (N = 40)	Mirtazapine exposed (N = 16)	SSRI-mirtazapine exposed (N = 18)	Psychiatric diagnosis unmedicated (N = 23)	df	χ^2	p Chi Square/ Kruskall Wallis
Psychiatric disorder at previous pregnancy (Yes/No)	%13/%87	%37/%63	%23/%76	%33/%67	3	3.71	0.294
Psychiatric disorder duration	58.66 ± 51.78	40.12 ± 40.94	77.55 ± 56.01	64.64 ± 55.49	3	4.79	0.187
New diagnosis at current pregnancy (Yes/No)	%15/%85	%38/%62	%0/%100	%13/%87	3	10.75	0.013
Previous treatment cessation history (Yes/No)	%67/32	%77/%23	%100/%0	%80/%20	3	7.40	0.060
Previous relaps after treatment cessation (Yes/No)	%58/%42	%67/%33	%100/%0	%55/%45	3	10.80	0.013
Pregnancy week as soon as relaps	12.37 ± 8.02	13.13 ± 8.69	11.88 ± 6.46	12.52 ± 7.73	3	0.06	0.996
Pregnancy week as soon as admission to hospital	15.47 ± 7.56	17.87 ± 9.97	15.33 ± 6.92	17.35 ± 10.93	3	0.51	0.917
The time to relaps (month)	6.56 ± 8.80	6.28 ± 11.53	7.19 ± 10	6.51 ± 7.52	3	0.95	0.812
The week of treatment onset	15.37 ± 7.98	18.80 ± 11.50	16.83 ± 7.14		2	0.90	0.635
The duration of treatment at pregnancy (week)	21.70 ± 9.77	21.5 ± 11.12	20.72 ± 8.70		2	0.18	0.913
Equivalent antidepressant dosage	27.45 ± 16.91	21.09 ± 8.75	^1EAD SSRI 27.47 ± 13.05		2	1.23	^1 0.539
			^2 EAD mirtazapine 23.33 ± 11.47		2	0.94	^2 0.625
The severity of disorder as soon as admission (Borderline mentally ill/Mildly ill/Moderately ill/Markedly ill/Severly ill/The most severly ill)	%5/%0/%33/%57/%2/%2	%6/%0/%50/%44/%0/%0	%0/%0/%5/%61/%34/%0	%0/%36/%55/%9/%0/%0	15	66.24	0.001
The severitv of disorder (Mild to moderate/ severe)	%37/%63	%56/%44	%5/%95	%9/%91	3	36.72	0.001
Inpatient treatment(Yes/no)	%5/%95	%18/%82	%39/%61	%0/%100	6	20.12	0.003

EAD: Equivalent antidepressant dosage.

Table 4. Comparison of the birth and infant outcomes of the groups.

	SSRI exposed (N = 40)	Mirtazapine exposed (N = 16)	SSRI-mirtazapine exposed (N = 18)	Psychiatric diagnosis unmedicated (N = 23)	Healthy Control (N = 23)	df	χ^2	P Chi Square/ Kruskall Wallis
The way of labour (vaginal/surgical delivery)	%38/%62	%37/%63	%45/%55	%31/%69	%34/%66	4	0.73	0.947
The category with regard to birth weight (Normal/LBW/Macrosomia)	%85/%10/%5	%93/%7/%0	%88/%6/%6	%86/%14/%0	%86/%8/%6	8	4.11	0.847
Gestation week of the birth	38,43 ± 1.23	38.99 ± 1.37	38.35 ± 1.40	38.09 ± 2.73	38.76 ± 1.70	4	5.99	0.200
Preterm /Early term /Term /Late term birth	%7/%50/%43/%0	%6/%25/%56/%12	%5/%50/%34/%11	%4/%26/%43/%9	%4/%26/%70/%0	12	17.56	0.129
Birth Weight(gr)	3153.17 ± 435.17	3251.25 ± 502.27	3191.38 ± 436.69	3052 ± 636.27	3193.70 ± 612.74	4	1.56	0.816
Birth lenght(cm)	49,91 ± 1.93	50.57 ± 1.60	49.75 ± 1.69	49.35 ± 2.76	50.71 ± 1.73	4	5.09	0.277
The time at NCU	1,05 ± 3.02	1.31 ± 3.02	0.57 ± 1.75	4.17 ± 18.73	2.95 ± 7.54	4	2.82	0.588
Staying at NCU (Yes/No)	%17/%83	%12/%88	%16/%84	%13/%87	%30/%70	4	2.88	0.577
Breatfeeding (Yes/No)	%90/%10	%93/%7	%100/%0	%90/%10	%100/%0	8	8.69	0.521
The time of breastfeeding (month)	6,45 ± 5,55	7.75 ± 5.56	9.47 ± 8.01	13.38 ± 8.01	8.54 ± 8.12	4	7.90	0.095
Neonatal bilirubinemia (Yes-Transient-mild /No)	%48/%52	%18/%82	%22/%78	%46/%54	%18/%82	8	9.86	0.275

LBW: Low Birth Weight NCU: Neonatal Intensive Care Unit.

Table 5. The investigation of the confounding effect of smoking and the severity of the disorder.

		^1SSRI exposed (N = 40)	^2Mirtazapine exposed (N = 16)	^3SSRI-mirtazapine exposed (N = 18)	^4Psychiatric diagnosis unmedicated (N = 23)	^5Healthy Control (N = 23)
Smoking
Yes	Preterm Birth (Yes/No)	1/12 2/25	0/7 1/8	1/7 0/9	1/4 0/18	2/2 1/16
No
Mantel-Haenszel p^1vs 2=0.646, p^1vs 3=0.792, p^1vs 4=0.875, p^1vs 5=0.554, p^2vs 3=0.509, p^2vs 4=0.541, p^2vs 5=0.614, p^3vs 4=0.683, p^3vs 5=0.335, p^4vs 5=0.448
Yes	Low Birth Weight (Yes/No)	0/13 4/23	0/7 1/8	1/7 0/9	1/4 1/17	1/3 2/15
No
Mantel-Haenszel p^1vs 2==.784, p^1vs 3=0.901, p^1vs 4=0.845, p^1vs 5=0.964, p^2vs 3=0.509, p^2vs 4=0.760, p^2vs 5=0.850, p^3vs 4=0.937, p^3vs 5=0.566, p^4vs 5=0.885
Yes	Staying at NCU (Yes/No)	1/12 6/21	1/6 1/8	3/5 0/9	2/3 5/13	1/3 2/15
No
Mantel-Haenszel p^1vs 2=0.968, p^1vs 3=0.720, p^1vs 4=0.430, p^1vs 5=0.965, p^2vs 3=0.896, p^2vs 4=0.334, p^2vs 5=0.853, p^3vs 4=0.344, p^3vs 5=0.892, p^4vs 5=0.383
The severity of the disorder
Mild to Moderate	Preterm Birth (Yes/No)	1/14 2/23	1/8 0/7	0/1 1/16	3/17 0/2
Severe
Mantel-Haenszel p^1vs 2=0.723, p^1vs 3=0.796, p^1vs 4=0.948, p^2vs 3=0.571, p^2vs 4=0.767, p^3vs 4=0.320
Mild to Moderate	Low Birth Weight (Yes/No)	0/15 4/21	1/8 0/7	0/1 1/16	3/17 0/2
Severe
Mantel-Haenszel p^1vs 2=0.786, p^1vs 3=0.615, p^1vs 4=0.613, p^2vs 3=0.571, p^2vs 4=0.767, p^3vs 4=0.320
Mild to Moderate	Staying at NCU (Yes/No)	2/13 5/20	1/8 1/6	0/1 3/14	3/17 0/2
Severe
Mantel-Haenszel p^1vs 2=0.959, p^1vs 3=0.917, p^1vs 4=0.816, p^2vs 3=0.630, p^2vs 4=0.619, p^3vs 4=0.593

Table 6. Correlation of the sociodemographic and clinical properties of the women with psychiatric diagnosis.

	Pregnancy week as soon as relaps	Pregnancy week as soon as admission to hospital	The week of treatment onset	The duration of treatment at pregnancy (week)
Education			r=−0.262*	r = 0.297*
Psychiatric disorder duration			r=−0.250*	r = 0.350*
The time to relaps (month)	r = 0.415**	r = 0.343*	r = 0.403**	r=−0.487**

*p ≤ 0.05 **p ≤ 0.001 r = effect size