A new look at the neonate's clinical presentation after in utero exposure to antidepressants in late pregnancy
A new look at the neonate's clinical presentation after in utero exposure to antidepressants in late pregnancy
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DOI：
10.1097/jcp.0b013e318173aa2e
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发表时间：
2008-06-01
影响因子：
2.9
通讯作者：
Beaulac-Baillargeon, Louise
中科院分区：
文献类型：
--
作者：
Boucher, Nina;Bairam, Aida;Beaulac-Baillargeon, Louise
目的：了解妊娠晚期暴露于抗抑郁药物的新生儿的症状，并提出这些症状的分类，以帮助临床评估暴露于抗抑郁药物的新生儿的效果。数据回顾性地从孕产妇和新生儿医院图表中提取。共有73名接触抗抑郁药的新生儿和73名未接触抗抑郁药的新生儿被纳入研究。收集文献中报道的与抗抑郁药暴露相关的新生儿症状。采用多元logistic回归分析来估计新生儿症状与抗抑郁药物暴露的关系。用析因分析对新生儿症状进行重新分组。结果：发现警觉性改变的风险增加（优势比[OR], 37； 95%可信区间[CI]， 8-174），肌肉张力改变（OR, 20; 95% CI, 5-71），喂养和胃肠道问题（OR, 3.8; 95% CI 1.7-8.1），呼吸急促（OR, 2.5; 95% CI, 1.1-5.3）和神经问题（8/73 vs 0/73; P = 0.006）。从析因分析中出现了与抗抑郁药暴露相关的三个具有统计学意义的症状群。其中两组与成人血清素能毒性和抗抑郁药停药综合征相似，而另一组与新生儿不成熟密切相关。结论：妊娠晚期暴露于抗抑郁药物的新生儿表现出的症状可分为三类。这种分组可能有助于开发一种有助于评估和护理暴露新生儿的新工具。
Objectives: To identify symptoms in neonates exposed to antidepressants in late pregnancy and to propose a categorization of these symptoms to help clinical assessment of antidepressant effects in exposed neonates.Methods:. Data were extracted retrospectively from maternal and neonatal hospital charts. A total of 73 neonates exposed to antidepressant and 73 nonexposed neonates were included. Neonatal symptoms reported in the literature to be related to antidepressant exposure were collected. Multiple logistic regression analysis was used to estimate the association of neonatal symptoms and antidepressant exposure. Factorial analysis was used to regroup the neonatal symptoms.Results: Increased risk of alertness alteration (odds ratio [OR], 37; 95% confidence interval [CI], 8-174), altered muscular tone (OR, 20; 95% CI 5-71), feeding and GI problems (OR, 3.8; 95% CI 1.7-8.1), tachypnea (OR, 2.5; 95% CI, 1.1-5.3), and neurological problems (8/73 vs 0/73; P = 0.006) were found. Three statistically significant clusters of symptoms associated with antidepressant exposures emerged from the factorial analysis. Two of these clusters were similar to those described in adults for serotonergic toxicity and antidepressant discontinuation syndrome while the other was closely related to neonatal immaturity.Conclusions: Symptoms expressed in neonates exposed to antidepressants in late pregnancy could be gathered in three clusters. This grouping could be useful to develop a new tool helping in the assessment and care of the exposed newborns.