Use of anti-depressants during pregnancy not linked with increased risk of stillbirth, infant death

Public release date: 1-Jan-2013
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Contact: Olof Stephansson
olof.stephansson@ki.se
JAMA and Archives Journals

CHICAGO In a study that included nearly 30,000 women from Nordic countries who had filled a selective serotonin reuptake inhibitor (SSRI) prescription during pregnancy, researchers found no significant association between use of these medications during pregnancy and risk of stillbirth, neonatal death, or postneonatal death, after accounting for factors including maternal psychiatric disease, according to a study in the January 2 issue of JAMA.

"Depression during pregnancy is common with prevalences ranging between 7 percent and 19 percent in economically developed countries. Maternal depression is associated with poorer pregnancy outcomes, including increased risk of preterm delivery, which in turn may cause neonatal morbidity and mortality," according to background information in the article. "Use of selective serotonin reuptake inhibitors during pregnancy has been associated with congenital anomalies, neonatal withdrawal syndrome, and persistent pulmonary hypertension of the newborn. However, the risk of stillbirth and infant mortality when accounting for previous maternal psychiatric disease remains unknown."

Olof Stephansson, M.D., Ph.D., of the Karolinska Institutet, Stockholm, Sweden and colleagues conducted a study to examine whether SSRI exposure during pregnancy was associated with increased risks of stillbirth, neonatal death, and postneonatal death. The study included women with single births from all Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden) at different periods from 1996 through 2007. The researchers obtained information on maternal use of SSRIs from prescription registries; maternal characteristics, pregnancy, and neonatal outcomes were obtained from patient and medical birth registries. The authors estimated relative risks of stillbirth, neonatal death, and postneonatal death associated with SSRI use during pregnancy taking into account maternal characteristics and previous psychiatric hospitalization.

Among 1,633,877 singleton births in the study, there were 6,054 stillbirths; 3,609 neonatal deaths; and 1,578 postneonatal deaths. A total of 29,228 (1.79 percent) of mothers had filled a prescription for an SSRI during pregnancy. The researchers found that women exposed to an SSRI had higher rates of stillbirth (4.62 vs. 3.69 per 1000) and postneonatal death (1.38 vs. 0.96 per 1000) than those who did not. The rate of neonatal death was similar between groups (2.54 vs. 2.21 per 1000). "Yet in multivariate models, SSRI use was not associated with stillbirth, neonatal death, or postneonatal death. Estimates were further attenuated when stratified by previous hospitalization for psychiatric disease," the authors write.

"The present study of more than 1.6 million births suggests that SSRI use during pregnancy was not associated with increased risks of stillbirth, neonatal death, or postneonatal death. The increased rates of stillbirth and postneonatal mortality among infants exposed to an SSRI during pregnancy were explained by the severity of the underlying maternal psychiatric disease and unfavorable distribution of maternal characteristics such as cigarette smoking and advanced maternal age."

"However, decisions regarding use of SSRIs during pregnancy must take into account other perinatal outcomes and the risks associated with maternal mental illness," the researchers conclude.

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(JAMA. 2013;309(1):48-54; Available pre-embargo to the media at http://media.jamanetwork.com)

Editor's Note: This study was funded by the Swedish Pharmacy Company and by the authors' affiliations. Olof Stephansson was supported by a postdoctorate scholarship from the Swedish Society of Medicine. All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

To contact Olof Stephansson, M.D., Ph.D., email.

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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.

Public release date: 1-Jan-2013
[ | E-mail | Share ]

Contact: Olof Stephansson
olof.stephansson@ki.se
JAMA and Archives Journals

CHICAGO In a study that included nearly 30,000 women from Nordic countries who had filled a selective serotonin reuptake inhibitor (SSRI) prescription during pregnancy, researchers found no significant association between use of these medications during pregnancy and risk of stillbirth, neonatal death, or postneonatal death, after accounting for factors including maternal psychiatric disease, according to a study in the January 2 issue of JAMA.

"Depression during pregnancy is common with prevalences ranging between 7 percent and 19 percent in economically developed countries. Maternal depression is associated with poorer pregnancy outcomes, including increased risk of preterm delivery, which in turn may cause neonatal morbidity and mortality," according to background information in the article. "Use of selective serotonin reuptake inhibitors during pregnancy has been associated with congenital anomalies, neonatal withdrawal syndrome, and persistent pulmonary hypertension of the newborn. However, the risk of stillbirth and infant mortality when accounting for previous maternal psychiatric disease remains unknown."

Olof Stephansson, M.D., Ph.D., of the Karolinska Institutet, Stockholm, Sweden and colleagues conducted a study to examine whether SSRI exposure during pregnancy was associated with increased risks of stillbirth, neonatal death, and postneonatal death. The study included women with single births from all Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden) at different periods from 1996 through 2007. The researchers obtained information on maternal use of SSRIs from prescription registries; maternal characteristics, pregnancy, and neonatal outcomes were obtained from patient and medical birth registries. The authors estimated relative risks of stillbirth, neonatal death, and postneonatal death associated with SSRI use during pregnancy taking into account maternal characteristics and previous psychiatric hospitalization.

Among 1,633,877 singleton births in the study, there were 6,054 stillbirths; 3,609 neonatal deaths; and 1,578 postneonatal deaths. A total of 29,228 (1.79 percent) of mothers had filled a prescription for an SSRI during pregnancy. The researchers found that women exposed to an SSRI had higher rates of stillbirth (4.62 vs. 3.69 per 1000) and postneonatal death (1.38 vs. 0.96 per 1000) than those who did not. The rate of neonatal death was similar between groups (2.54 vs. 2.21 per 1000). "Yet in multivariate models, SSRI use was not associated with stillbirth, neonatal death, or postneonatal death. Estimates were further attenuated when stratified by previous hospitalization for psychiatric disease," the authors write.

"The present study of more than 1.6 million births suggests that SSRI use during pregnancy was not associated with increased risks of stillbirth, neonatal death, or postneonatal death. The increased rates of stillbirth and postneonatal mortality among infants exposed to an SSRI during pregnancy were explained by the severity of the underlying maternal psychiatric disease and unfavorable distribution of maternal characteristics such as cigarette smoking and advanced maternal age."

"However, decisions regarding use of SSRIs during pregnancy must take into account other perinatal outcomes and the risks associated with maternal mental illness," the researchers conclude.

###

(JAMA. 2013;309(1):48-54; Available pre-embargo to the media at http://media.jamanetwork.com)

Editor's Note: This study was funded by the Swedish Pharmacy Company and by the authors' affiliations. Olof Stephansson was supported by a postdoctorate scholarship from the Swedish Society of Medicine. All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

To contact Olof Stephansson, M.D., Ph.D., email.

---

[ | E-mail | Share ]

?

AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.

Source: http://www.eurekalert.org/pub_releases/2013-01/jaaj-uoa122712.php

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Rep. King says Boehner promises Sandy aid votes

WASHINGTON (AP) ? A New York lawmaker says House Speaker John Boehner has promised votes to aid victims of Superstorm Sandy by Jan. 15.

Republican Rep. Peter King says the speaker will schedule a vote Friday for $9 billion in flood insurance and another on Jan. 15 for a remaining $51 billion in the package. The votes will be taken by the new Congress that will be sworn in Thursday.

Boehner's decision to cancel an expected vote Tuesday night had outraged lawmakers from New York, New Jersey and elsewhere, including many in his own party.

King said Boehner made the promise in a private meeting with lawmakers from affected states. King and others said they were now satisfied that the aid will be forthcoming.

Source: http://news.yahoo.com/rep-king-says-boehner-promises-sandy-aid-votes-204703768--finance.html

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Obama says budget deals show a path forward when officials focus on what's right for country

During an oddly jokey statement at the White House as the fiscal deadline bore down Monday afternoon, President Obama said, "I'm going to be president for the next four years. I?hope." He was warning Republicans that, yes, they'd have to deal with him for a while. But it was, to be sure, a strange moment. Could he actually have been joking about assassination? About impeachment? The?apocalypse? Or has everyone just had enough of these negotiations??

Source: http://news.yahoo.com/obama-says-budget-deals-show-043844754.html

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Source: http://taxcruncher.co.uk/online-business-marketer-and-why-it-is-the-best-seo-software/

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Eleven Ways to Avoid Answering a Question: A Year in Review

When my grandfather was alive, each of his children and grandchildren was responsible for reporting to him about the world in which they worked. He loved knowledge; he always had. As the only scientist in the family, I was in charge of ?science.? This never quite seemed fair and yet I did what I could until the day he asked me to explain dark matter. I am a broadly trained scientist. I have worked on bacteria, birds, plants, insects and a great deal else. But, when pressed, late in the evening, dark matter was beyond my comfort zone. I faltered. Sometimes with my grandfather, faltering could be propped up with grandstanding, but on this particular day there was no such doing. He knew I was guessing. His shoulders slumped and he announced softly, ?I don?t think I am ever going to learn everything.? My ignorance was the BS that broke the camel?s back.

In part because of my grandfather I have always felt a responsibility to answer ?questions people ask about science. This year, I decided I would make this responsibility more conscious. I would try to focus much of my writing on answering questions that came up in my daily life, questions that I am responsible for because I am a scientist. It was a sort of New Year?s resolution. My other resolution was to write shorter articles.

1?Sitting around enjoying a glass of wine with my family and our friends Ari Lit and Michelle Trautwein, Ari asked, Hey dude, why do we drink alcohol? Do monkeys drink alcohol? This led me to think about the big story of alcohol and, in as much, to write a whole series about our complex relationship with the yeasts that, as waste, produce our favorite drinks. It ended up becoming a forty thousand word online series, about alcohol, civilization and yeast. So much for the resolution to write short articles. Also, I forgot to check on the monkeys.

2?My favorite questions tend to come from kids and earnest parents. This year at my daughter?s school, every third student and then every other students and then, jeez, almost every student seemed to have lice. Parents asked me, ?what should we do about lice?? This was a follow-up to an article I had written years prior in response to a similar query. I was able to tell the story of how the louse problem (or success, depending on your perspective) came to be, over the last million years. But I failed to really answer what a parent should do if their kid gets lice. It turns out parents whose kids have lice don?t want to hear about ancient hominids and their lice. ?Go figure.

Image 1. Picture of the louse species, Pthirus pubis, descended from an interaction between a human ancestor and a gorilla ancestor and that is all I am saying. Photo courtesy of the CDC.

3-In the last chapter of my book The Wild Life of Our Bodies I argue for a more serious gardening of nature in the places we live. Reading this, someone wondered about the ways in which we garden evolution itself. She emailed asking, Could we favor the evolution of good species in our houses? I wasn?t sure and am still not, but the question prompted me to reconsider the ways in which we have gardened evolution historically. I wrote the Garden of Our Neglect about this history. I then started to consider how we might favor the presence (if not evolution) of beneficial species on our bodies and in our homes. This led me to propose the Ecological Theory of Disease and to write Letting Biodiversity Get Under Our Skin, ?and How Clean Living is Bad for You. I also wrote an article about what our body might be doing to favor beneficial species in Your Appendix Could Save Your Life. None of these articles really told anyone which species to plant much less engender in their invisible gardens of indoor life.

4-Another night with friends, we sat around talking about paleo diets. Ari asked who we should count as our ancestors, which ancestors should we consider if we were to eat ancestral diets? This debate inspired the piece Were Our Ancient Ancestors Vegetarians and then How to Eat Like a Chimpanzee. Later when Ari tried an essentially all nut and fruit super-fiber diet I found myself writing about the Hidden Truth about Calories. With these articles, I learned about diet, but I also learned that people can get very angry when it comes to discussing food. I never really answered Ari?s question.

5-At one evening talk associated with the Museum of Life and Science in Durham, NC, someone asked me why her armpits smell sweet when she lives in the desert. She asked me that question in Durham, not in a desert, so I felt compelled to take her word for it rather than sniff around the story, but I did begin to wonder about what we do and don?t know about the microbial smells produced on our bodies and those of, for example, dogs, so I wrote Why Sick People Smell Bad. The article was fun, but I still don?t know why the woman had sweet pits; perhaps it is just her nature.

6-My daughter (who sometimes seems to channel the pure inquisitivness of my grandfather) asked me ?Why are our bodies warm and not cold?? This is the kind of question she asks so as to avoid going to bed. It led me to write the article How Killer Fungus May Have Made us Hot Blooded. The article offers a partial, possible, speculative ?answer to her question, which is her favorite kind of answer because it means she can stay up later as she asks follow-up questions.

7?My son has started asking, ?papa, who took your hair?? I told him, as I told my daughter when she was smaller, that the squirrels took it for their nest. This just seemed to make him afraid of squirrels so I decided to figure out the real answer, the result was a story in New Scientist (unfortunately pay-walled) about the mystery of baldness and its evolution. Balding, it turns out, is fascinating, but why we bald is still largely unresolved. Back to the squirrels.

8?I sometimes introduce talks about social insects by mentioning the similarities between insect and human societies and the idea that insect societies can allow us to learn about our own. In response (and during election season), someone recently asked ?who would the ants vote for?? The closest I could get to an answer was to discuss how other animals (mostly honey bees) choose their leaders. I figured out that we know far less about leaders in other societies, including those of ants, than I had thought.

9?Piotr Naskrecki visited my house and found, in my basement, a species of camel cricket apparently native to Japan. He also found, to my wife?s dismay, two species of ?interesting roaches.? This spurred me to ask other people about their camel crickets, which caused me to have to answer how a Japanese camel cricket has come to take over our basements? I don?t really have an answer yet, though if you check out the website there are ways for you to help me find one.

10?For a number of years now, people have been offering me story ideas. ?Man, you should totally write about?? Its often difficult to follow up on such ideas, but this year I tried.? When my family and I were living in Parma, Italy Donato Grosso asked me if I knew about the species of crab living under Rome. ?That,? he said, ?would be a good story.? It was. It became ?new species of crab living in Rome.? A visit to Girona, Spain where a friend had built a niche in his house for animals to colonize got me wondering about the niches in our cities that we have built for wild species. Pera said, ?you should write about it.? I did, in the form of a story about the most common bird in the world, the house sparrow. There were no questions here, but even without a question to answer I seem to have written something slightly different from what Donato or Pera might have imagined.

11-Finally, I have started to try to answer the question I have heard most often throughout my career, including from my grandfather, ?what do I do about the ants in my kitchen?? Answering this question has required figuring out what the heck is going on with ants in kitchens and backyards and so I wrote one article about a backyard discovery made by English majors, another about a discovery made by an eight year old and another still about how little we seem to know about the most common ant species in eastern North America. I also recruited Eleanor Spicer to write Dr. Eleanor?s Book of Common Ants. ?None of these answered the question about what to do about the ants in your kitchen, though maybe the distraction bought me some time.

Image 2. Camponotus pennsylvannicus, a common backyard (and occasionally kitchen) ant. Photo by Alex (the great) Wild.

In short, although I?ve written something like 200,000 words this year, very few seem to have directly answered the questions I was asked. So much for my New Year?s resolution, though maybe part of the problem is that we still know so little about so many fields that it is nearly impossible to make it to the end of a story without encountering the unknown. Perhaps I can try to write shorter answers, answers short enough that I don?t get to what we don?t know. History is not on my side. I seem incapable of writing short articles (one of my shortest articles this year was repeatedly described as ?long form?). Also, I come from a long history of ?long form? people. My grandfather?s stories went long and, well, his father was apparently worse. When asked to comment on the history of the Episcopal church in his town, Greenville, Mississippi, my great grandfather wrote that he could not write about the history of the Episcopal church in Greenville without commenting on the history of the Episcopal church more generally. And he could not, he said, write about the Lutheran church in general without commenting upon the history of religion. And so he began. My people. It seems we start at the very beginning and answer a question similar too but not identical too the one we were asked. In this light, if my granddad were still around, I?d tell him now that, yes, I can explain dark matter now, but before I do I need to explain the big bang, which, ironically is what I do in my first article of 2013. So stay tuned and send me your questions. But don?t be surprised if, in commenting upon the history of your question, I need to comment on a broader church, the history of life or even the universe.

Go ahead and post your science questions you think should be answered in 2013 here?

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Source: http://rss.sciam.com/click.phdo?i=99ab2efd4ff4dcf471ab956bd98de747

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Saudis flee dry kingdom to Bahrain for New Year

RIYADH, Saudi Arabia (AP) ? Residents of Saudi Arabia, where booze and New Year's celebrations are banned, flooded into neighboring Bahrain in search of festivities to ring in 2013.

More than 80,000 cars crossed a causeway over the Gulf to Bahrain Monday night to celebrate New Year's Eve, the Saudi newspaper Al-Youm reported on Tuesday. Saudi Arabia adheres to a strict interpretation of Islam and bans alcohol as well as celebrations of Christmas and New Year's Eve. It also prohibits unrelated men and women from mingling.

Saudis and foreign residents of the oil-rich kingdom frequently take the half-hour drive across the causeway to Bahrain on weekends, filling bars, movie theaters and hotels in the capital Manama. Some conservative Bahraini lawmakers, however, want the government to ban alcohol and close nightclubs.

Al-Youm said a few hours before midnight, the line of cars waiting to cross King Fahd bridge stretched for a half-mile with traffic police, security and passport officers out in force to keep the revelers flowing.

Associated Press

Source: http://hosted2.ap.org/APDEFAULT/cae69a7523db45408eeb2b3a98c0c9c5/Article_2013-01-01-Saudi-New%20Year%20Exodus/id-02a56e11dd1a46538e53784d3acbaaac

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'Hobbit' Dominates 2012's Final Box Office

'Django Unchained,' 'Les Miserables' also enjoy strong business during the year's final box office weekend.
By Josh Wigler

Martin Freeman in "The Hobbit"
Photo: Warner Bros. Entertainment

Source: http://www.mtv.com/news/articles/1699496/the-hobbit-box-office.jhtml

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