Malm Heli, Klaukka Timo, Neuvonen Pertti J
Teratology Information Service, HUSLAB, Helsinki University Central Hospital, Finland.
Obstet Gynecol. 2005 Dec;106(6):1289-96. doi: 10.1097/01.AOG.0000187302.61812.53.
To study the effects of selective serotonin reuptake inhibitors (SSRIs) on pregnancy outcome.
We performed a population-based study of women exposed to SSRIs during pregnancy (n = 1782). Data were derived from a national project in Finland, established by 3 governmental organizations. In that project, the Drug Reimbursement Register, the Medical Birth Register, the Register of Congenital Malformations, and the Register of Induced Abortions have been linked. Comparisons were made between women with SSRI purchases to matched controls and between women with purchases in different trimesters. Only singleton pregnancies were included. Primary outcomes were major malformations, preterm birth, small for gestational age, low birth weight, and treatment in neonatal special or intensive care unit. Analyses were based on logistic models.
Major malformations were not more common in infants or fetuses of women with first trimester SSRI purchases (n = 1,398) when compared with controls with no drug purchases (P = .4). Of infants born to mothers with SSRI purchases in the 3rd trimester, 15.7% were treated in special or intensive care unit compared with 11.2% of infants exposed only during the 1st trimester (P = .009, adjusted odds ratio 1.6, 95% confidence interval 1.1-2.2). We found no increased risk of preterm birth (< 37 weeks), birth 32 weeks of gestation or less, small for gestational age, or low birth weight in women with purchases in each trimester or during the 2nd and 3rd trimesters when compared with women with only 1st trimester purchases.
Use of SSRIs during pregnancy is not independently associated with increased risk of adverse perinatal outcome other than need for treatment in neonatal special or intensive care unit.
研究选择性5-羟色胺再摄取抑制剂（SSRI）对妊娠结局的影响。
我们对孕期暴露于SSRI的女性（n = 1782）进行了一项基于人群的研究。数据来源于芬兰的一个国家项目，该项目由3个政府组织设立。在该项目中，药品报销登记册、医疗出生登记册、先天性畸形登记册和人工流产登记册相互关联。将购买SSRI的女性与匹配的对照组进行比较，并对不同孕期购买药物的女性进行比较。仅纳入单胎妊娠。主要结局包括严重畸形、早产、小于胎龄儿、低出生体重以及新生儿特殊或重症监护病房治疗。分析基于逻辑模型。
与未购买药物的对照组相比，孕早期购买SSRI的女性（n = 1398）所生婴儿或胎儿出现严重畸形的情况并不更常见（P = 0.4）。孕晚期购买SSRI的母亲所生婴儿中，15.7%在特殊或重症监护病房接受治疗，而仅在孕早期暴露的婴儿这一比例为11.2%（P = 0.009，调整优势比1.6，95%置信区间1.1 - 2.2）。我们发现，与仅在孕早期购买药物的女性相比，各孕期或孕中期及晚期购买药物的女性早产（< 37周）、妊娠32周及以下分娩、小于胎龄儿或低出生体重的风险并未增加。
孕期使用SSRI除了与新生儿特殊或重症监护病房治疗需求相关外，与不良围产期结局风险增加并无独立关联。
