Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Room 2365, Stanford, CA, 94305-5723, USA.
Psychopharmacology (Berl). 2011 Sep;217(2):211-9. doi: 10.1007/s00213-011-2270-z. Epub 2011 Apr 16.
This study evaluated the question whether length of in utero exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants might affect neonatal outcome and psychomotor development in infancy.
Birth outcome was determined in the offspring of 55 women with major depressive disorder who used SSRI medication for different durations during their pregnancies. At an average age of 14 months, children underwent a pediatric examination and an evaluation with the Bayley Scales of Infant Development (BSID-II).
Duration of in utero exposure to SSRIs was negatively associated with total Apgar scores, specifically the activity subscale. Odds ratios for a low score (<2) on this scale were 3.8 and 6.0 at 1 and 5 min, respectively. Newborns with longer exposure were more often admitted to the Neonatal Intensive Care Unit (p < .03). Mental Development Index scores of the infants were not associated with the length of gestational exposure to SSRIs. A longer duration of exposure increased the risk for lower Psychomotor Developmental Index and Behavioral Rating Scale scores in infancy (p = 0.012 and p = 0.007, respectively) on the BSID-II.
The findings provide evidence that the length of prenatal SSRI antidepressant use can affect neonatal adjustment and can have an effect on psychomotor test scores in infancy. Importantly, the children's mental development and motor function by neurological examination were within the normal range. Timing of exposure to SSRIs during susceptible periods of fetal development and variations in the severity of maternal depression may have contributed to the associations.
本研究旨在探讨胎儿在子宫内暴露于选择性 5-羟色胺再摄取抑制剂（SSRIs）抗抑郁药的时间长短是否会影响新生儿结局和婴儿期的精神运动发育。
对 55 名患有重度抑郁症的女性的后代进行了出生结局评估，这些女性在怀孕期间使用了不同时间的 SSRIs 药物。在平均 14 个月龄时，儿童接受了儿科检查和贝利婴幼儿发展量表第二版（BSID-II）评估。
胎儿暴露于 SSRIs 的时间与总阿普加评分呈负相关，特别是活动子量表。该量表评分低于 2 分的比值比在 1 分钟和 5 分钟时分别为 3.8 和 6.0。暴露时间较长的新生儿更常被送入新生儿重症监护病房（p<.03）。婴儿的精神发育指数评分与 SSRIs 妊娠期暴露时间长短无关。暴露时间延长会增加婴儿期精神运动发育指数和行为评定量表评分较低的风险（BSID-II 分别为 p=0.012 和 p=0.007）。
这些发现提供了证据表明，产前使用 SSRIs 抗抑郁药的时间长短会影响新生儿的适应能力，并可能对婴儿期的精神运动测试评分产生影响。重要的是，儿童的精神发育和运动功能通过神经学检查均在正常范围内。暴露于 SSRIs 的时间在胎儿发育敏感时期以及母亲抑郁严重程度的变化可能导致了这些关联。
