(1047) Association between psychopharmacotherapy and excessive gestational weight gain

To determine the relationship between use of medications to treat mood disorders (psychopharmacotherapy, PPT) and excessive gestational weight gain (EGWG).

Study Design: This retrospective cohort study included all pregnant patients who delivered live, term, singleton newborns at seven hospitals within a large health system in New York from 2019-2023. Patients with missing GWG data were excluded. The primary exposure was prenatal exposure to PPT (yes/no), which included selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), dopamine-norepinephrine reuptake inhibitors (DNRIs), benzodiazepines, and others. The primary outcome was EGWG (yes/no), defined as weight gain exceeding the upper limit recommended by the Institute of Medicine based on pre-pregnancy BMI. Multiple logistic regression was performed to evaluate the association between PPT and EGWG, adjusting for covariate factors.

Results: A total of 87,385 pregnancies were included for analysis and EGWG occurred in 49.50% (n=43,261). Patients with mental health conditions had EGWG more often than patients without such conditions (49.3% vs. 54.3%, respectively; aOR 1.26, 95% CI 1.10-1.45). Among the individual PPT categories, only SSRI monotherapy was associated with increased odds of EGWG (aOR 1.21, 95% CI 1.09-1.33) compared to patients without a mental health disorder. Patients taking two medications had higher odds of EGWG (aOR 1.62, 95% CI 1.23-2.16) than those taking one medication (aOR 1.11, 95% CI 1.03-1.20). Regression results are shown in Figure.

Conclusion: Pregnant patients with mental health disorders are at higher risk for EGWG, especially those treated with SSRIs and those receiving multiple PPT medications. Our findings suggest that the type of PPT affects GWG, underscoring the need for tailored management strategies to mitigate excessive weight gain in these patients