Document Detail


Treatment with selective serotonin reuptake inhibitors in the third trimester of pregnancy: effects on the infant.
MedLine Citation:
PMID:  15963005     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Pharmacotherapy in pregnant women is often necessary to treat chronic or relapsing depression or anxiety disorders. Studies that have evaluated the safety of selective serotonin reuptake inhibitors (SSRIs) in early pregnancy have not shown an enhanced risk of major congenital malformations and these results may have contributed to the increasing use of these agents during pregnancy. Fewer studies have assessed the safety of SSRIs in the third trimester of pregnancy. This article reviews available human data on the safety of SSRI treatment in the third trimester. The main purpose is to present and discuss the existing literature on the risks to the infant and to suggest treatment guidelines for the use of SSRIs in late pregnancy. The use of SSRIs in the third trimester has shown various perinatal complications, most frequently respiratory distress, irritability and feeding problems. Further studies are needed to evaluate the frequency of these complications and to elucidate whether the symptoms represent a direct serotonergic effect or are a drug withdrawal effect. Studies have shown conflicting results with respect to whether SSRI exposure decreases birthweight and increases the risk of premature delivery. A few case reports have described intracerebral haemorrhage in neonates after maternal SSRI treatment, but it is not known whether the frequency of such complications is higher than in unexposed neonates. Data on possible long-term effects of prenatal SSRI exposure on psychomotor and behavioural development are very sparse. Our interpretation of the current literature suggests that the risk of not receiving adequate antidepressant treatment in the third trimester when indicated outweighs the risks of adverse events in the infant. Thus, adequate pharmacological treatment should not be withheld from a depressed pregnant woman in late pregnancy. However, the neonate should be monitored for possible adverse effects after maternal use of an SSRI in the third trimester.
Authors:
Hedvig Nordeng; Olav Spigset
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Drug safety : an international journal of medical toxicology and drug experience     Volume:  28     ISSN:  0114-5916     ISO Abbreviation:  Drug Saf     Publication Date:  2005  
Date Detail:
Created Date:  2005-06-20     Completed Date:  2006-08-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9002928     Medline TA:  Drug Saf     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  565-81     Citation Subset:  IM    
Affiliation:
Department of Pharmacotherapeutics, University of Oslo, Oslo, Norway. h.m.e.nordeng@medisin.uio.no
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MeSH Terms
Descriptor/Qualifier:
Female
Humans
Infant, Newborn
Maternal-Fetal Exchange / drug effects*
Pregnancy
Pregnancy Trimester, Third / drug effects*
Prenatal Exposure Delayed Effects
Risk Assessment / statistics & numerical data
Serotonin Uptake Inhibitors / adverse effects*,  therapeutic use
Chemical
Reg. No./Substance:
0/Serotonin Uptake Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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