Virginia Via Research Day Book 2026

Medical Student Research Biomedical

07 ANALYZING THE IMPACT OF ANTIDEPRESSANTS ON PROTHROMBIN TIME AND POSTPARTUM OUTCOMES FOR PREGNANT WOMEN

Natasha Singh, OMS-II; Kara Bucci, OMS-ll, Dr. Blaise Costa Corresponding author: nsingh01@vcom.edu

VCOM-Virginia, Blacksburg, Virginia

factors, or special considerations. Specifically, prothrombin time will be used to better characterize medication class effects on postpartum hemorrhage risk. Methods: This study utilized the All of Us NIH database, with deidentified records of 41,001 pregnant patients. Our study population included those with the condition of pregnancy as well as a diagnosis of a depressive and/or anxiety disorder, totaling 21,006 patients. Results were specified for pregnancy, specific antidepressant group taken during pregnancy, health outcome-ex.) postpartum hemorrhage, and prothrombin time. The number of patients in this population who also had a specific maternal health outcome were compared to the total population who are pregnant and not prescribed antidepressants. Prothrombin time was then extracted for cohorts involving postpartum hemorrhage. Analysis was done by calculating relative risk, attributable risk, odds ratio and number needed to harm. Results: The relative risk of pregnant women experiencing postpartum hemorrhage while taking SSRI, SNRI, or bupropion is: RR=1.31, RR=0.97, and RR= 1.38 respectively. These values will be compared to relative risk of non-medicated pregnant women who have anxiety and/or depression, and have experienced postpartum hemorrhage. Relative risk of other negative postpartum outcomes such as

postpartum depression, preeclampsia, premature labor and miscarriage are currently being calculated and compared to control. Analysis of prothrombin values for patients’ taking antidepressants during pregnancy compared to the prothrombin values of pregnant patients’ who are not on antidepressants are currently in the process of being analyzed. Conclusion: Data is still being analyzed. References: 1Dubovicky M, Belovicova K, Csatlosova K, Bogi E. Risks of using SSRI / SNRI antidepressants during pregnancy and lactation. Interdiscip Toxicol. 2017 Sep;10(1):30-34. doi: 10.1515/intox-2017-0004. PMID: 30123033; PMCID: PMC6096863. 2Heikkinen T, Ekblad U, Kero P, Ekblad S, Laine K. Citalopram in pregnancy and lactation. Clin Pharmacol Ther. 2002 Aug;72(2):184-91. doi: 10.1067/mcp.2002.126181. PMID: 12189365. 3Koren G, Ornoy A. Clinical implications of selective serotonin reuptake inhibitors-selective serotonin norepinephrine reuptake inhibitors pharmacogenetics during pregnancy and lactation. Pharmacogenomics. 2018 Sep 1;19(14):1139-1145. doi: 10.2217/pgs 2018-0076. Epub 2018 Aug 14. PMID: 30105921. 4Main, E. K., Cape, V., Abreo, A., Vasher, J., Woods,

Context: The treatment of anxiety and depression disorders in pregnancy involves an intricate risk benefit analysis between the risks of antidepressant medication and the risks of untreated mental health disorders on maternal and fetal health outcomes6. Untreated depression in pregnancy has an increased risk of intrauterine growth restriction, premature labor and low birth weight1,3. Pregnancy complicates known drug pharmacokinetics such as cytochrome P450 enzyme activity and coagulation state, which highlights the importance of further study2,3,5. Most pregnant patients will continue taking anti depressants, most commonly SSRIs, SNRIs, or bupropion during pregnancy. However, there is little research comparing classes of antidepressants and their correlation with various negative postpartum outcomes. In particular, postpartum hemorrhage is the leading cause of severe maternal morbidity and of preventable maternal mortality in the United States4. Objective/Hypothesis: A retrospective analysis was performed to elucidate correlations between the three most commonly prescribed antidepressant classes and various negative postpartum outcomes such as postpartum hemorrhage, postpartum depression and psychosis, preeclampsia, and miscarriage. The intent is to utilize a vast sample to better inform antidepressant use in pregnancy, particularly those with unique comorbidities, risk

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