Description du projet
Vers un traitement antidépresseur personnalisé pendant la grossesse
Jusqu’à 10 % de femmes suivent un traitement antidépresseur pendant la grossesse. Cependant, la moitié d’entre elles arrête le traitement par peur de l’effet potentiel sur l’embryon. L’interruption du traitement augmente le risque de rechute et entraîne de graves conséquences. Étant donné que, jusqu’à présent, seules les données épidémiologiques déterminent les facteurs de risque, le projet PregnancyAD, financé par l’UE, va intégrer des caractéristiques démographiques et cliniques ainsi que des données génétiques provenant d’une large population représentative du Danemark. La prise en compte du manque de connaissances génétiques dans le domaine contribuera à identifier les femmes à haut risque de rechute après arrêt de leur traitement antidépresseur pendant la grossesse. Mais surtout, cela permettra de formuler des recommandations pour un traitement antidépresseur optimal pendant la grossesse.
Objectif
Antidepressants are the mainstay of pharmacological treatment for depressive and anxiety disorders in the perinatal period, and up to one in ten pregnant women take them. Among these women, over 50% discontinue antidepressants during pregnancy due to fear of possible adverse fetal effects. However, discontinuation may increase the risk of relapse, which can also have profound negative impacts. Evidence on perinatal relapse risk following antidepressant discontinuation during pregnancy is sparse and limited to highly selected populations. Moreover, the only factors considered in studies so far have been simple demographics and clinical features, while genetic profiling is conspicuously absent.
The project aims to address knowledge gaps which urgently need to be understood in order for clinical care to provide personalized antidepressant treatment recommendations around pregnancy. This overarching objective will identify women at low or high relapse risk after discontinuing antidepressants during pregnancy and determine risk factors of relapse to enable personal risk estimates for the first time, in a large representative population, combining demographics, clinical features and genetic data retrieved from Danish national registers and the Integrative Psychiatric Research (iPSYCH) cohort.
The project will provide a unique opportunity due to its multidisciplinary nature and innovative combinations of genetics and epidemiology. The proposed research will benefit from the expertise in genetics, genomics, and psychiatric epidemiology of the supervisors, and the fellow’s multidisciplinary skills in epidemiology and biostatistics applied on large, highly complicated datasets. The fellow will acquire state-of-the-art skills in the analysis of genetic data, planning, and management by training-through-research along with coursework. This project will form a fundamental leap towards her future independent career as a leading and international recognized epidemiologist.
Champ scientifique
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Régime de financement
MSCA-IF - Marie Skłodowska-Curie Individual Fellowships (IF)Coordinateur
8000 Aarhus C
Danemark