Depression is increasingly common in women of child-bearing age, with studies suggesting that 10 – 15% of pregnant women may suffer from depression during pregnancy (Gavin et al. 2005). Although observational studies have shown very little evidence that antidepressant use during pregnancy is associated with congenital malformations (Jordan et al. 2016, Ban et al. 2014, O’Brien et al. 2008), there is increasing evidence suggesting a potential neurodevelopmental impact (Sullivan et al. 2013, Rai et al. 2013, Boukhris et al. 2013).
Studying outcomes in this area is made particularly difficult not only by the inability and impracticality of performing randomised control trials in pregnant women, but also the confounding by indication of depression itself in observational studies (Källén, 2012). Another concern is the way risks regarding medication use in pregnancy are framed in the scientific literature and translations in the media, clinic and public health advice. This framing could contribute to mothers feeling guilty for treating their depression, thus potentially exacerbating their condition and its impact on their offspring.
In this project, we will use the Clinical Practice Research Datalink (CPRD) and epigenetic and genetic data from ALSPAC to triangulate evidence to examine and tease apart the potential links between untreated depression and antidepressant use with adverse pregnancy, birth and neurodevelopmental outcomes.