Alexis Christine Carson

• Carson, Alexis Christine; Zidan, Mahmoud; Olstad, Emilie Willoch; Gervin, Kristina; Galesloot, Tessel E. & Scholte, Iris [Show all 9 contributors for this article] (2026). Genetically Informed Research Designs in Perinatal Pharmacoepidemiology: A Methodological Overview. Drug Safety. ISSN 0114-5916. 49(7), p. 761–773. doi: 10.1007/s40264-026-01647-9. Full text in Research Archive Show summary

  Despite the widespread use of medications during pregnancy, ethical and methodological barriers to clinical trials make observational studies necessary for evaluating medication safety in this population. Observational studies are prone to biases that often limit their validity due to the lack of randomization; integrating genetic information through discordant sibling designs, polygenic scores, and Mendelian randomization can address several confounding issues. However, application of these three approaches in perinatal pharmacoepidemiology has been limited. Complementing traditional designs with these genetically informed research designs can tackle common biases and strengthen causal inference. This paper focuses on applying genetically informed research designs to child outcomes in perinatal pharmacoepidemiology by reviewing various methods, discussing their strengths and limitations, and examining their application to date, as well as considerations for implementing them in future research. Such considerations include the availability of genetic data, the complexity of integrating genetic data with existing epidemiological data, and selection of appropriate genetic instruments for analyses. Incorporating causal inference in perinatal pharmacoepidemiology can ultimately contribute to enhancing safe medication use during pregnancy.

• Chatha, Zeenat Fatima; Trinh, Nhung; Rostami, Sina; Bergink, Veerle; Carson, Alexis Christine & Magnus, Per [Show all 7 contributors for this article] (2026). Timing of antidepressant initiation postpartum and maternal mental health outcomes up to 18 months after childbirth. The European Journal of Psychiatry. ISSN 0213-6163. 40(2). doi: 10.1016/j.ejpsy.2026.100352. Full text in Research Archive
• Carson, Alexis Christine; Trinh, Nhung; Nordeng, Hedvig Marie Egeland; Liu, Xiaoqin; Munk-Olsen, Trine & Eberhard-Gran, Malin [Show all 8 contributors for this article] (2025). Initiating antidepressant treatment in pregnancy: Timing, intensity, and influential maternal and familial factors. Journal of Affective Disorders. ISSN 0165-0327. 388. doi: 10.1016/j.jad.2025.119726. Full text in Research Archive Show summary

  Objective: To describe the timing and intensity of antidepressant initiation in pregnancy using longitudinal trajectories of antidepressant prescription fills to identify associated sociodemographic, lifestyle, somatic, mental health, pregnancy, and paternal factors. Methods: This population-based cohort within the Norwegian Mother, Father and Child Cohort study linked to MoBa Genetics and the Prescribed Drug Registry included 1879 women with a new episode of self-reported depression/anxiety during pregnancy. Antidepressants were measured by week and average daily dose. Results: There were 87 initiators, from which we identified three prescription fill trajectories: Early-pregnancy initiators with rapid discontinuation (n = 41, 47.1 %), Early-pregnancy initiators with mid-pregnancy discontinuation (n = 30, 34.5 %), and Early-mid pregnancy initiators with continuation (n = 16, 18.4 %) and three dose trajectories: Low dose with discontinuation (n = 45, 51.7 %), High dose with discontinuation (n = 26, 29.9 %), and Medium dose with continuation (n = 16, 18.4 %). Thyroid disorder was associated with Early initiators with rapid discontinuation (adjusted relative risk ratios (aRRR): 4.15, 95 % CI: 1.56–11.03) compared to Unmedicated. Other psychotropics pre-pregnancy increased the likelihood of being Early initiators with mid-pregnancy discontinuation and High dose discontinuers compared to Unmedicated. Higher maternal genetic liability for depression was strongly associated with Early initiators with mid-pregnancy discontinuation (aRRR = 8.57, 95 % CI: 3.09–23.74), High dose discontinuers and Medium dose continuers across comparisons. Adverse reproductive history, immigration and alcohol pre-pregnancy emerged as important factors. Conclusions: Approximately 5 out of 100 women with a new episode of depression/anxiety initiated an antidepressant during pregnancy, predominantly in early pregnancy, with most discontinuing early to mid-pregnancy. Identified factors can be utilized by clinicians to provide personalized treatment guidance.

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