SSRI use during pregnancy and risk of stillbirth and neonatal mortality.
SSRI use during pregnancy and risk of stillbirth and neonatal mortality.
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怀孕期间使用 SSRI 会增加死产和新生儿死亡的风险。
DOI：
10.1176/appi.ajp.2012.11081251
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发表时间：
2013
期刊：
影响因子：
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通讯作者：
Poulsen,HenrikE
中科院分区：
文献类型：
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作者：
Jimenez-Solem,Espen;Andersen,JonTrærup;Petersen,Morten;Broedbaek,Kasper;Lander,AndersRune;Afzal,Shoaib;Torp-Pedersen,Christian;Poulsen,HenrikE
目的研究子宫内暴露于选择性血清素再摄取抑制剂（SSRIs）是否会增加死胎或新生儿死亡的风险。方法作者使用丹麦生育数据库进行了一项基于人群的队列研究，以确定1995年至2008年间丹麦的每一次出生。暴露于SSRIs的时间是根据标准治疗剂量计算的，并根据处方登记分配包装大小。暴露分为妊娠早期、中期和晚期暴露。采用多元逻辑回归模型。结果作者确定了920620例新生儿；死产发生率为0.45%，新生儿死亡率为0.34%。共有12425名后代在怀孕期间暴露于SSRI。死产与妊娠早期SSRI使用（校正优势比=0.77,95% CI= 0.43-1.36）、妊娠早期和中期使用（优势比=0.84,95% CI= 0.40-1.77）或妊娠早期、中期和晚期使用（优势比=1.06,95% CI= 0.71-1.58）无关。新生儿死亡率与妊娠早期使用SSRI（优势比=0.56,95% CI= 0.25-1.24）、妊娠早期和中期使用SSRI（优势比=0.90,95% CI= 0.37-2.17）或妊娠早期、中期和晚期使用SSRI（优势比=1.27,95% CI= 0.82-1.99）无关。结论：本研究发现妊娠期接触ssri类药物与死产或新生儿死亡率之间没有关联。
ObjectiveThe authors investigated whether in utero exposure to selective serotonin reuptake inhibitors (SSRIs) increases the risk of stillbirth or neonatal mortality.MethodThe authors conducted a population-based cohort study using the Danish Fertility Database to identify every birth in Denmark between 1995 and 2008. Time of exposure to SSRIs was calculated on the basis of standard treatment dosages and dispensed pack sizes according to the prescription register. Exposure was divided into first-, second-, and third-trimester exposure. Multivariate logistic regression models were used.ResultsThe authors identified 920,620 births; the incidence of stillbirths was 0.45%, and the incidence of neonatal mortality was 0.34%. A total of 12,425 offspring were exposed to an SSRI during pregnancy. Stillbirth was not associated with first-trimester SSRI use (adjusted odds ratio=0.77, 95% CI=0.43–1.36), first- and second-trimester use (odds ratio=0.84, 95% CI=0.40–1.77), or first-, second-, and third-trimester use (odds ratio=1.06, 95% CI=0.71–1.58). Neonatal mortality was not associated with SSRI first-trimester use (odds ratio=0.56, 95% CI=0.25–1.24), first- and second-trimester use (odds ratio=0.90, 95% CI=0.37–2.17), or first-, second-, and third-trimester use (odds ratio=1.27, 95% CI=0.82–1.99).ConclusionsThis study found no association between exposure to SSRIs during pregnancy and stillbirth or neonatal mortality.