Yonkers Kimberly A, Blackwell Katherine A, Glover Janis, Forray Ariadna
Department of Psychiatry.
Annu Rev Clin Psychol. 2014;10:369-92. doi: 10.1146/annurev-clinpsy-032813-153626. Epub 2013 Dec 2.
Women in their reproductive years are at risk of experiencing depressive and anxiety disorders. As such, it is likely that pregnant women will undergo treatment with antidepressants. We review the risk of adverse birth outcomes and neonatal complications subsequent to antidepressant use in pregnancy. An inconsistent literature shows that antidepressant exposure is associated with shortened gestations and diminished fetal growth; these effects are small. Transitory neonatal signs are seen in some neonates after exposure to antidepressants in utero. No specific pattern of malformations has been consistently associated with antidepressants, with the possible exception of paroxetine and cardiac malformations. There is inconclusive evidence of a link between antidepressants in late pregnancy and persistent pulmonary hypertension in the newborn. Extensive study finds that antidepressants cannot be considered major teratogens. It is likely that confounding factors contribute to a number of the adverse effects found to be associated with antidepressant use in pregnancy.
处于生育年龄的女性有患抑郁症和焦虑症的风险。因此，孕妇很可能会接受抗抑郁药治疗。我们综述了孕期使用抗抑郁药后不良出生结局和新生儿并发症的风险。文献结果不一，表明接触抗抑郁药与妊娠缩短和胎儿生长受限有关；这些影响较小。一些新生儿在子宫内接触抗抑郁药后会出现短暂的新生儿体征。除了帕罗西汀与心脏畸形可能存在关联外，没有特定的畸形模式与抗抑郁药始终相关。关于妊娠晚期使用抗抑郁药与新生儿持续性肺动脉高压之间的联系，证据尚无定论。广泛的研究发现，抗抑郁药不能被视为主要致畸剂。混杂因素很可能导致了许多与孕期使用抗抑郁药相关的不良反应。
