Potential confounders
included established risk factors for preeclampsia
and factors related to depression severity during the baseline:
age (as a quadratic spline), primiparity (no prior deliveries
recorded in the database for a woman; multiparas are identified
only when prior deliveries are recorded), multifetal gestation,
diabetes, obesity, renal disease, number of depression
claims (up to 20 gestational weeks), other mental health
disorders, a binary composite of other antidepressant indications
(sleep disorders, migraine, or other pain-related conditions:
fibromyalgia, rheumatoid arthritis, inflammatory bowel
disease, or gastrointestinal ulcers) (definitions in Web Table 1,
the first of 4 Web tables and a Web Appendix posted to the
Journal’s website (http://aje.oxfordjournals.org/)), number of
psychiatrist visits and mental health hospitalizations, and
dispensings for benzodiazepines, antipsychotics, and anticonvulsants
(binary variables). The number of distinct prescription
drugs excluding antidepressants, physician visits (<10,
10–19, 20–29, 30), and non-mental health hospitalizations
during the baseline were considered as markers of comorbidity
(31). The number of antidepressant classes and the total
days’ supply of all antidepressant dispensings (<90, 90–364,
365) during the year before the last menstrual period were
used to capture antidepressant history.
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