Neonatal Adaptation in Infants Prenatally Exposed to Antidepressants- Clinical Monitoring Using Neonatal Abstinence ScoreReportar como inadecuado




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Background

Intrauterine exposure to antidepressants may lead to neonatal symptoms from the central nervous system, respiratory system and gastrointestinal system. Finnegan score Neonatal Abstinence Score, NAS has routinely been used to assess infants exposed to antidepressants in utero.

Aim

The purpose was to study neonatal maladaptation syndrome in infants exposed to selective serotonin reuptake inhibitors SSRI or serotonin-norepinephrine reuptake inhibitors SNRI in utero.

Method

Retrospective cohort study of women using antidepressants during pregnancy and their infants. Patients were identified from the electronic health record system at Karolinska University Hospital Huddinge containing pre-, peri- and postnatal information. Information was collected on maternal and infant health, social factors and pregnancy. NAS sheets were scrutinized.

Results

220 women with reported 3rd trimester exposure to SSRIs or SNRIs and who gave birth between January 2007 and June 2009 were included. Seventy seven women 35% used citalopram, 76 used 35% sertraline, 34 15% fluoxetine and 33 15% other SSRI-SNRI. Twenty-nine infants 13% were admitted to the neonatal ward, 19 were born prematurely. NAS was analyzed in 205 patients. Severe abstinence was defined as eight points or higher on at least two occasions on a scale with maximum 40 points, mild abstinence as 4 points or higher on at least two occasions. Seven infants expressed signs of severe abstinence and 46 22% had mild abstinence symptoms. Hypoglycemia plasma glucose <2.6 mmol-L was found in 42 infants 19%.

Conclusion

Severe abstinence in infants prenatally exposed to antidepressants was found to be rare 3% in this study population, a slightly lower prevalence than reported in previous studies. Neonatal hypoglycemia in infants prenatally exposed to antidepressant may however be more common than previously described.



Autor: Lisa Forsberg , Lars Navér, Lars L. Gustafsson, Katarina Wide

Fuente: http://plos.srce.hr/



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