抗抑郁药物的胎盘转运
Placental passage of antidepressant medications.
作者信息
Hendrick Victoria, Stowe Zachary N, Altshuler Lori L, Hwang Sun, Lee Emily, Haynes Desiree
机构信息
Mood Disorders Research Program, UCLA Neuropsychiatric Institute and Hospital, University of California-Los Angeles, 300 Medical Plaza, Suite 2345, Los Angeles, CA 90095, USA.
出版信息
Am J Psychiatry. 2003 May;160(5):993-6. doi: 10.1176/appi.ajp.160.5.993.
OBJECTIVE
This study determined the placental transfer of antidepressants and their metabolites.
METHOD
A total of 38 pregnant women taking citalopram, fluoxetine, paroxetine, or sertraline participated. Maternal and umbilical cord blood samples were obtained to determine antidepressant and metabolite concentrations.
RESULTS
Antidepressant and metabolite concentrations were detectable in 86.8% of umbilical cord samples. The mean ratios of umbilical cord to maternal serum concentrations ranged from 0.29 to 0.89. The lowest ratios were for sertraline and paroxetine; the highest were for citalopram and fluoxetine. Maternal doses of sertraline and fluoxetine correlated with umbilical cord concentrations of these medications.
CONCLUSIONS
Umbilical cord concentrations of antidepressants and their metabolites were almost invariably lower than corresponding maternal concentrations. Maternal doses predicted umbilical concentrations of fluoxetine and sertraline. Mean umbilical cord to maternal serum ratios were significantly lower for sertraline than fluoxetine, suggesting that sertraline may produce less fetal medication exposure than fluoxetine near delivery.
目的
本研究确定了抗抑郁药及其代谢产物的胎盘转运情况。
方法
共有38名服用西酞普兰、氟西汀、帕罗西汀或舍曲林的孕妇参与。采集母血和脐血样本以测定抗抑郁药及其代谢产物的浓度。
结果
86.8%的脐血样本中可检测到抗抑郁药及其代谢产物的浓度。脐血与母血血清浓度的平均比值在0.29至0.89之间。舍曲林和帕罗西汀的比值最低；西酞普兰和氟西汀的比值最高。母亲服用的舍曲林和氟西汀剂量与这些药物的脐血浓度相关。
结论
抗抑郁药及其代谢产物的脐血浓度几乎总是低于相应的母血浓度。母亲服用剂量可预测氟西汀和舍曲林的脐血浓度。舍曲林的脐血与母血血清平均比值显著低于氟西汀，表明在分娩时舍曲林对胎儿的药物暴露可能比氟西汀少。
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