Epidemiology, Research Paper Example

I reviewed the following article: “Depression and Serotonin Reuptake Inhibitor Treatment as a Risk Factor for Preterm Birth” from the journal Epidemiology .

The purpose of this study  is to assess to what extent (if any) the role of a mother taking SSRIs (a typical antidepressant) results in greater risks of a preterm birth.  In order to examine this question, the authors conduct a prospective cohort study of 2,793 pregnant mothers. The pregnant women were enrolled between March 2005 and May 2009.  Data regarding pre-term births were obtained from existing hospital records by medical record reviewers who were blinded to a woman’s depression and medication status.

In order to explore the research question, the researchers employed binary logistic regression with the (dichotomous) outcome variable measuring whether the woman had a pre-term birth or not.  The researchers modeled the exposure, SSRI consumption, in four different ways: 1) women who had a major depressive episode (via interview) and used SRIs in pregnancy; 2) women who had a major depressive episode and did not use an SRI; 3) women who did not have a major depressive episode but used an SRI; 4) women had no major depressive episode and did not take medication.

The researchers bifurcated their results based on differences in exposure (depressive episode versus SRI use).  Overall, the study found that there was no clear association between major depressive order (without medication) and preterm birth. An association did exist, however, between SRI use and preterm births.

Overall, while the researchers found the relationship between SRI use and preterm births worthy of further research, they were also leery that the relationship might be due to confounding of psychiatric illness, particularly psychiatric illness besides major depression.

Reference:

Yonkers KA, Norwitz ER, Smith MV, Lockwood CJ, Gotman N, Luchansky E, Lin H, Belanger K. Depression and Serotonin Reuptake Inhibitor Treatment as Risk Factors for Preterm Birth.  Epidemiology, 23(5), 677-685.