A nested case-control study recently published in the BMJ has investigated the link between antidepressant (AD) classes, of use throughout pregnancy and gestational diabetes mellitus (GDM) risk. 20,905 cases of GDM were observed following week 20 of pregnancy and matched with 209,050 controls for gestational age/year of pregnancy. Among all participants, 9,741 (4.2%) of women were exposed to ADs and this was found to be associated with increased GDM risk (adjusted odds ratio [aOR]: 1.19, 95% CI: 1.08 – 1.30), specifically for venlafaxine (aOR: 1.27, 95% CI: 1.09 – 1.49) and amitriptyline (aOR: 1.52, 95% CI: 1.25 – 1.84). GDM risk was heightened when drugs such as serotonin norepinephrine reuptake inhibitors, tricyclic ADs or both were used for a long duration, but this was not the case for selective serotonin reuptake inhibitors. From the analysis, the study confirms that ADs (specifically venlafaxine and amitriptyline) are linked to an increased risk of GDM and highlights the need for further research in the challenging area of depression during pregnancy. The full details of the study can be accessed here.
Contributed by Australian Medication Safety Services Associate – Isabella Singh