(283) Trends in antidepressant use during early pregnancy in Germany between 2005 and 2020

Background: Little is known on the prevalence of antidepressant use in early pregnancy over time.

Objectives: We aimed to describe the utilization of antidepressants in early pregnancy between 2005 and 2020 in Germany.

Methods: Using the GePaRD database (claims data from ~20% of the German population), we identified all pregnancies beginning between 2005 and 2020 in women aged 13 to 49 for each year. Stratified by year of pregnancy beginning, we determined the proportion of pregnancies exposed to antidepressants during early pregnancy among all pregnancies beginning in the respective year. Pregnancies were defined as exposed to antidepressants in an early phase if either the supply of a prescription filled before the beginning of the pregnancy overlapped the beginning of the pregnancy, if a prescription occurred within the first eight weeks of pregnancy, or both. We used established algorithms developed for GePaRD to identify pregnancies, to classify their outcome and estimate their beginning.

Results: Overall, we identified 2.7 million pregnancies in GePaRD; the number per year ranged between about 114,000 (2006) and about 207,000 (2019). Among all pregnancies, 46,441 (1.72%) were classified as exposed to antidepressants in an early phase. The prevalence of exposed pregnancies among all pregnancies almost doubled between 2005 and 2020, from 1.05% to 1.95%. Most pregnancies were considered as exposed due to overlapping supply. Among exposed pregnancies, citalopram was the antidepressant which most often led to exposure. 71.5% of pregnancies exposed to antidepressants in an early phase ended in live births.

Conclusions: The prevalence of antidepressant use in early pregnancy increased between 2005 and 2020 in Germany.