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Clinical Epidemiology Volume 15, 2023 - Issue
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ORIGINAL RESEARCH

Maternal Depression and Antidepressant Use During Pregnancy and Associations with Depressive Symptoms and Suicidality in Adolescent Children

Devora Beck-Pancer1 School of Public Health, University of California, Berkeley, CA, USA;2 School of Medicine, University of California, San Francisco, CA, USACorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0001-9291-4288View further author information
ORCID Icon,
Sara Aghaee3 Division of Research, Kaiser Permanente Northern California, Oakland, CA, USAORCID Iconhttps://orcid.org/0000-0003-4912-5069View further author information
ORCID Icon,
Alysia Swint1 School of Public Health, University of California, Berkeley, CA, USA;4 School of Medicine, George Washington University, Washington, DC, USAORCID Iconhttps://orcid.org/0009-0001-8183-209XView further author information
ORCID Icon,
Julia Acker1 School of Public Health, University of California, Berkeley, CA, USAORCID Iconhttps://orcid.org/0000-0003-2139-7118View further author information
ORCID Icon,
Julianna Deardorff1 School of Public Health, University of California, Berkeley, CA, USA;3 Division of Research, Kaiser Permanente Northern California, Oakland, CA, USAORCID Iconhttps://orcid.org/0000-0002-4708-5289View further author information
ORCID Icon &
Ai Kubo3 Division of Research, Kaiser Permanente Northern California, Oakland, CA, USAORCID Iconhttps://orcid.org/0000-0002-1035-828XView further author information
ORCID Icon
Pages 613-628 | Received 25 Aug 2022, Accepted 20 Apr 2023, Published online: 08 May 2023

Figures & data

Figure 1 Inclusion criteria.

Notes: International Classification of Disease, 9th edition codes. Depression diagnosis: 296.20-296.25, 296.30-296.35, 300.4, 311. aSubstance use disorder: 291.0, 291.1, 291.2, 291.3, 291.4, 291.5, 291.81, 291.82, 291.89, 291.9, 292.0, 292.11, 292.12, 292.2, 292.81, 292.82, 292.83, 292.84, 292.85, 292.89, 292.9, 303.00, 303.01, 303.02, 303.90, 303.91, 303.92, 304.00, 304.01, 304.02, 304.10, 304.11, 304.12, 304.20, 304.21, 304.22, 304.30, 304.31, 304.32, 304.40, 304.41, 304.42, 304.50, 304.51, 304.52, 304.60, 304.61, 304.62, 304.70, 304.71, 304.72, 304.80, 304.81, 304.82, 304.90, 304.91, 304.92, 305.00, 305.01, 305.02, 305.20, 305.21, 305.22, 305.30, 305.31, 305.32, 305.40, 305.41, 305.42, 305.50, 305.51, 305.52, 305.60, 305.61, 305.62, 305.70, 305.71, 305.72, 305.80, 305.81, 305.82, 305.90, 305.91, 305.92, 648.33. bEpilepsy: 333.2, 345.00, 345.01, 345.10, 345.11, 345.2, 345.3, 345.40, 345.41, 345.50, 345.51, 345.70, 345.71, 345.80, 345.81, 345.90, 345.91, 649.43. cBipolar disorder: 296.00, 296.01, 296.02, 296.03, 296.04, 296.05, 296.06, 296.10, 296.11, 296.12, 296.13, 296.14, 296.15, 296.16, 296.40, 296.41, 296.42, 296.43, 296.44, 296.45, 296.46, 296.50, 296.51, 296.52, 296.53, 296.54, 296.55, 296.56, 296.60, 296.61, 296.62, 296.63, 296.64, 296.65, 296.66, 296.7, 296.80, 296.81, 296.89, 301.13. dSchizophrenia: 295.00, 295.01, 295.02, 295.03, 295.04, 295.05, 295.10, 295.11, 295.12, 295.13, 295.14, 295.15, 295.20, 295.21, 295.22, 295.23, 295.24, 295.25, 295.30, 295.31, 295.32, 295.33, 295.34, 295.35, 295.40, 295.41, 295.42, 295.43, 295.44, 295.45, 295.50, 295.51, 295.52, 295.53, 295.54, 295.55, 295.60, 295.61, 295.62, 295.63, 295.64, 295.65, 295.70, 295.71, 295.72, 295.73, 295.74, 295.75, 295.80, 295.81, 295.82, 295.83, 295.84, 295.85, 295.90, 295.91, 295.92, 295.93, 295.94, 295.95. eNon-antidepressant psychiatric medications: Anxiolytics and hypnotic (benzodiazepines and non-benzodiazepines), antiepileptic and mood stabilizer, antipsychotic, stimulant, and non-stimulant medications.
Abbreviations: KPNC, Kaiser Permanente Northern California; IPV, Intimate Partner Violence.
Figure 1 Inclusion criteria.

Table 1 Selected Characteristics by Exposure to Maternal Depression and Antidepressant Use During the Prenatal Period, N (%)

Table 2 Selected Characteristics by Depressive Symptoms and Suicidality in Adolescents, N (%)

Table 3 Association of Maternal Depression and Antidepressant Use During the Prenatal Period with Depressive Symptoms and Suicidality in Adolescent Children

Figure 2 Association of maternal depression and antidepressant use during the prenatal period with depressive symptoms in adolescent children. (a) Main Model: Med = Any antidepressants, ≥ 1 purchase. (b) Sensitivity Analysis 1: Med = Any antidepressants, ≥ 2 purchases. (c) Sensitivity Analysis 2: Med = SSRI monotherapy, ≥ 1 purchase.

Notes: All models were clustered by mother and adjusted for birth sex of adolescent, maternal age at delivery, maternal race and ethnicity, pregravid depression diagnosis, prenatal anxiety diagnosis, parity, and prenatal Medicaid insurance. ***p-value ≤0.001.
Abbreviations: OR, adjusted odds ratio; Med, Antidepressant exposure group; Med, Adolescents with mothers who had depression and used antidepressants during the prenatal period; No-Med, Adolescents with mothers who had depression and did not use antidepressants during the prenatal period; NDNM, Adolescents with mothers who neither had depression nor used antidepressants during the prenatal period; SSRI, selective serotonin reuptake inhibitor.
Figure 2 Association of maternal depression and antidepressant use during the prenatal period with depressive symptoms in adolescent children. (a) Main Model: Med = Any antidepressants, ≥ 1 purchase. (b) Sensitivity Analysis 1: Med = Any antidepressants, ≥ 2 purchases. (c) Sensitivity Analysis 2: Med = SSRI monotherapy, ≥ 1 purchase.

Figure 3 Association of maternal depression and antidepressant use during the prenatal period with suicidality in adolescent children. (a) Main Model: Med = Any antidepressants, ≥ 1 purchase. (b) Sensitivity Analysis 1: Med = Any antidepressants, ≥ 2 purchases. (c) Sensitivity Analysis 2: Med = SSRI monotherapy, ≥ 1 purchase.

Notes: All models were clustered by mother and adjusted for birth sex of adolescent, maternal age at delivery, maternal race and ethnicity, pregravid depression diagnosis, prenatal anxiety diagnosis, parity, and prenatal Medicaid insurance. ** p-value ≤0.01. *** p-value ≤0.001.
Abbreviations: OR, adjusted odds ratio; Med, Antidepressant exposure group; Med, Adolescents with mothers who had depression and used antidepressants during the prenatal period; No-Med, Adolescents with mothers who had depression and did not use antidepressants during the prenatal period; NDNM, Adolescents with mothers who neither had depression nor used antidepressants during the prenatal period; SSRI, selective serotonin reuptake inhibitor.
Figure 3 Association of maternal depression and antidepressant use during the prenatal period with suicidality in adolescent children. (a) Main Model: Med = Any antidepressants, ≥ 1 purchase. (b) Sensitivity Analysis 1: Med = Any antidepressants, ≥ 2 purchases. (c) Sensitivity Analysis 2: Med = SSRI monotherapy, ≥ 1 purchase.

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