title: Paediatric outcomes following intrauterine exposure to serotonin reuptake inhibitors: a systematic review.
abstract: The use of serotonine reuptake inhibitors (SRIs) is increasing among Danish pregnant women. This systematic review addresses the potential adverse effects on the foetus and child of maternal SRI medication. The literature indicates a slightly increased risk of cardiovascular malformations and persistent pulmonary hypertension of the new-born, while evidence regarding the risk of preterm labour, low birth weight, low Apgar score, prolonged QT interval and miscarriage is less clear. An estimated 20-30% of infants will have neonatal symptoms following intrauterine SRI exposure. The symptoms may be caused by SRI withdrawal, toxicity or their overlap, but symptom aetiology basically remains controversial. The infants may exhibit neurological, gastrointestinal, autonomic, endocrine or respiratory symptoms. Although the symptoms are self-limited, the families may be seriously affected. In general, studies do not address this important aspect. Evidence concerning long-term effects is surprisingly sparse and many studies have important methodological limitations. However, present evidence does not convincingly indicate detrimental long-term effects. Until sufficient safety studies have been carried out, SRI must be used with caution in pregnancy and every treatment of the pregnant woman should be thoroughly considered.
authors: Pædiatrisk Afdeling, Sygehus Lillebælt, Kolding, Denmark. jfg@grejsdalen.dk
authors: Jesper
authors: J
authors: Fenger-Grøn
authors: Morten
authors: M
authors: Thomsen
authors: Kristian Skytte
authors: KS
authors: Andersen
authors: Rasmus Gaardskær
authors: RG
authors: Nielsen
mesh_terms: D000022:Abortion, Spontaneous / Q000139:chemically induced; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D018376:Cardiovascular Abnormalities / Q000139:chemically induced; D002648:Child; D003866:Depressive Disorder / Q000188:drug therapy*; D005260:Female; D005333:Fetus / Q000187:drug effects*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000139:chemically induced; D007223:Infant; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced*; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors