![]() ![]() Postpartum OCD symptoms may consist of obsessional intrusive thoughts concerning contamination or aggression, leading to excessive overprotection or avoidance of the child or avoidance of the feared situation (e.g., harming the newborn). A longitudinal study following pregnant women until 9 months postpartum found a high prevalence of OCD during pregnancy (average prenatal point estimate = 2.9%), and the cumulative incidence of new OCD diagnoses was estimated at 9% by 6 months postpartum. The perinatal period appears to be a time of high risk for the onset, relapse or exacerbation of OCD. OCD causes significant distress to patients, impairing both work and social functioning. Obsessive‐compulsive disorder (OCD) is a psychiatric disorder characterized by the presence of intrusive thoughts (obsessions) and ritualistic behaviour (compulsions). Our findings highlight the importance of continuity of treatment throughout the perinatal period. Continuers with a single prescription fill during pregnancy or no fill postpartum may have higher risks for these outcomes. Among pregnant women with pre-existing OCD, we found similar probabilities of a postpartum visit for OCD or mood/anxiety disorders in antidepressant continuers compared to unexposed and discontinuers. Continuers in pregnancy without antidepressant fill in the first three months postpartum had higher probability for postpartum visit for mood/anxiety disorders compared to discontinuers (HR = 3.84, 95% CI: 1.49, 9.92). The likelihood of a postpartum OCD visit was higher in pregnancies having only one prescription fill during pregnancy compared to unexposed (HR = 3.44, 95% CI: 1.24, 9.54) or discontinuers (HR = 2.49, 95% CI: 0.91, 6.83). In weighted analyses, we found no difference in the probability of a postpartum visit for OCD or MADs with antidepressant continuation compared to unexposed and discontinuers. We estimated crude and propensity score weighted hazard ratio (HRs) of postpartum visit for OCD and mood/anxiety disorders using Cox proportional hazard models. We defined three groups based on antidepressant prescriptions filled in the 2 years before pregnancy to delivery: (i) unexposed ( n = 449) (ii) discontinuers ( n = 346), i.e., with pre-pregnancy antidepressant fills only (iii) continuers ( n = 522), i.e., with antidepressant fills before and during pregnancy. We identified 1317 women with live-birth singleton pregnancies and having outpatient/inpatient visits for OCD in the 4 years pre-pregnancy from the Danish registries. The association between antidepressant continuation during pregnancy and postpartum mental health in women with obsessive-compulsive disorder (OCD) is uncertain.
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