Birth outcomes after prenatal exposure to antidepressant medication

Chronic Maternal Fluoxetine Infusion in Pregnant Sheep: Effects on the Maternal and Fetal Hypothalamic-Pituitary-Adrenal Axes

“…It and other SSRIs have become increasingly used for the treatment of depression in pregnancy because of their effectiveness and lower incidence of maternal side effects and wider safety margin compared with tricyclic antidepressants and monoamine oxidase inhibitors (4,5). However, there have been several reports that use of these drugs during pregnancy can increase the incidence of adverse pregnancy outcomes, including preterm delivery, fetal growth restriction, and poor neonatal adaptation (5)(6)(7)(8). There is also evidence for postnatal consequences of prenatal SSRI exposure, including reduced weight gain, slight delays in psychomotor development and motor movement control, and our own findings of reduced facial and heart rate responses to painful stimuli (9 -11).…”

Fetal Effects of Selective Serotonin Reuptake Inhibitor Treatment During Pregnancy: Immediate and Longer Term Child Outcomes

“…Several studies reported that continuous or later gestational exposure was associated with reduced gestational age 20,22 and led to higher rates of preterm birth 24 . One study that investigated the effect of dose of SSRI concluded that only higher than average doses were associated with premature delivery and reduced gestational age 24 , however the slightly larger study by Hendrick et al 29 failed to find an association. Few studies considered the impact of important maternal and child variables associated with the risk of preterm birth, and when adjustment for confounding variables did occur it differed between studies ( Table 1).…”

“…SSRI exposure was also associated with a higher prevalence of preterm birth in five identified studies 20,[24][25][26][27] . Not all, however, confirmed such an association, with seven studies failing to replicate an association [28][29][30][31][32][33][34] . The study by Oberlander et al 22 employed a large record linkage design (n = 1575 early exposed and 1925 later exposed), with prospective ascertainment of information through medical records and found an association between length of SSRI exposure and gestational age at birth.…”

“…The report by Kallen 25 extended the earlier report by Ericsson et al 43 from the Swedish Birth Register and highlighted that the larger sample size altered the conclusion. Seven studies failed to demonstrate an association 21,24,29,[31][32][33] , however these tended to include smaller sample sizes ( Table 1).…”

Transtorno bipolar do humor e gênero

“…Todavia, os tricíclicos, quando usados próximos ao parto, podem induzir a toxicidade perinatal transitória ou sintomas de descontinuação, como inquietação, irritabilidade, letargia e hipotonia, além de taquicardia, retenção urinária e constipação (McElhatton et al, 1996). Já os ISRS, como a fluoxetina, associam-se a baixo peso ao nascer (Hendrick et al, 2003). É possível que depressões refratárias se associem a baixo peso independentemente do uso de medicação (Burt e Hendrick, 2005).…”