Agut-Quijano T, Martínez-Nadal S, Elizari-Saco M J, Sala-Castellví P, Vila-Cerén C, Raspall-Torrent F
Servicio de Neonatología y Pediatría, SCIAS, Hospital de Barcelona, Grup Assistència, España.
Rev Neurol. 2006;42(11):660-2.
The treatment with selective serotonin reuptake inhibitors (SSRIs) is widely prescribed in pregnant women. Its gestational use is not associated with an increased risk of major foetal anomalies when used in their recommended doses. A SSRI-related neonatal syndrome has been described secondary to withdrawal in infants exposed to these drugs during the last trimester of pregnancy. However, little is known about neonatal psychopharmacology.
An infant whose mother received treatment with paroxetine (20 mg/kg/day) during the third trimester was born prematurely and presented withdrawal symptoms within few days after birth. Symptoms were irritability with constant crying, shivering, increased muscle tone, coreiform movements and feeding problems. Only supportive care was needed and symptoms disappeared by two weeks of age.
In utero exposure to SSRIs during the last trimester through delivery may result in a self-limited neonatal behavioural syndrome that can be managed with supportive care. Its increasing incidence in neonates may be due to a greater frequency of its gestational use. All these neonates should be followed-up closely looking forward withdrawal symptoms in the first days of life. We need a better understanding of SSRIs effects and pharmacokinetics, and further research should focus on whether it is safe to use SSRIs during the last trimester.
选择性5-羟色胺再摄取抑制剂（SSRI）治疗在孕妇中应用广泛。按推荐剂量使用时，其孕期使用与胎儿出现重大畸形的风险增加无关。已描述了一种与SSRI相关的新生儿综合征，继发于在妊娠晚期接触这些药物的婴儿停药后。然而，关于新生儿精神药理学的了解甚少。
一名母亲在妊娠晚期接受帕罗西汀（20毫克/千克/天）治疗的婴儿早产，出生后几天内出现戒断症状。症状包括烦躁不安、持续哭闹、颤抖、肌张力增加、抽搐样动作和喂养问题。仅需支持性护理，症状在两周龄时消失。
在妊娠晚期直至分娩期间子宫内接触SSRI可能导致一种自限性新生儿行为综合征，可通过支持性护理进行处理。其在新生儿中的发病率增加可能是由于孕期使用频率更高。所有这些新生儿在出生后的头几天应密切随访，留意戒断症状。我们需要更好地了解SSRI的作用和药代动力学，进一步的研究应聚焦于在妊娠晚期使用SSRI是否安全。
