Neonatal adaptation following intrauterine antidepressant exposure: assessment, drug assay levels, and infant development outcomes
| Autor: | Rolland Kohan, Olav Spigset, Martha Lappas, Andrew R. Johnson, Megan Galbally, Andrew J. Lewis |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Pediatrics medicine.medical_specialty Time Factors Umbilical cord 03 medical and health sciences 0302 clinical medicine Child Development Pregnancy Risk Factors medicine Humans Maternal-Fetal Exchange Depression (differential diagnoses) Exposure assessment business.industry Depression Age Factors Infant Newborn Infant medicine.disease Fetal Blood Child development Adaptation Physiological Antidepressive Agents 030227 psychiatry Pregnancy Complications Abstinence Syndrome medicine.anatomical_structure In utero Maternal Exposure Prenatal Exposure Delayed Effects Pediatrics Perinatology and Child Health Antidepressant Female business 030217 neurology & neurosurgery |
| Zdroj: | Pediatric research. 82(5) |
| ISSN: | 1530-0447 |
| Popis: | BackgroundAlthough a meta-analysis has confirmed the association between antidepressant exposure in utero and subsequent poor neonatal adaptation, few identified studies included drug levels or standardized measures and only two studies followed up children who developed symptoms beyond infancy.MethodsThe study draws on the Mercy Pregnancy and Emotional Wellbeing Study and reports on 42 women/infant pairs at delivery. In all, 31 women continued to take antidepressants until delivery and 11 ceased earlier in pregnancy. Poor neonatal adaptation was assessed twice daily for up to 6 days by using the Neonatal Abstinence Scoring System (NASS). Drug levels were analyzed in umbilical cord blood and maternal blood obtained at delivery.ResultsIn total, 76% (32 of 42) of neonates exposed to antidepressants had symptoms observed on the NASS. These symptoms occurred up to 5 days postpartum with 25% having symptoms that persisted for more than 3 days. The most frequent symptoms were correlated most closely to antidepressant drug levels. Elevated NASS scores were found to be associated with poorer fine motor development at 6 months of age.ConclusionsPoor neonatal adaptation may be more common than previously recognized. The NASS was observed to be an effective assessment and monitoring measure. Research following symptomatic infants beyond the neonatal period is required. |
| Databáze: | OpenAIRE |
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