0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Letters to the Editor |

Problems With Maternal Antidepressant Treatment and Neonatal Outcomes Study

Thomas R. Einarson, PhD; Gideon Koren, MD; Adrienne Einarson, RN
Arch Gen Psychiatry. 2007;64(7):866. doi:10.1001/archpsyc.64.7.866-a.
Text Size: A A A
Published online

Extract

The article by Oberlander et al1 attempts to address potential perinatal adverse effects of selective serotonin reuptake inhibitor (SSRI) use during pregnancy while accounting for depression in the mother. However, we believe that some of the conclusions they made are not supported by the data presented.

In the conclusion in the abstract, 2 statements they made were not supported by the data. They conclude that (1) “ . . . exposure was associated with an increased risk of low birth weight. . . . ” The definition of low birth weight is lower than 2500 g2 and in neither the introduction (ie, statement of purpose) nor the “Methods” section, did the authors indicate that low birth weight was an outcome that they investigated. They mention only average weight of newborns and the proportion falling lower than the 10th percentile (ie, small for gestational age). In fact, the rates of infants with weights less than the 10th percentile were 8.5%, 8.1%, and 7.4% in the 3 groups, which reveals the opposite of what the authors concluded. In the normal population, we would expect that 10% would fall at or lower than the 10th percentile (that is its definition). However, they found much lower rates, all of which are statistically significant (all P values <.05) when tested using the binomial test. Consequently, the proportions of babies who were small for gestational age were significantly lower in all 3 groups than what would be expected according to population norms. (2) “ . . . maternal illness severity was accounted for,” which was also incorrect, as they themselves stated in the “Comment” section. The complex description of propensity scores lacked validity and consequently were rather meaningless. Therefore, both of these statements are misleading, especially if an individual only reads the abstract.

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();