米氮平在妊娠和哺乳期的应用：来自一系列病例的数据

Mirtazapine in pregnancy and lactation: data from a case series.

作者信息

Smit Mirte, Wennink Hanneke, Heres Marion, Dolman Koert M, Honig Adriaan

机构信息

From the Departments of *Pediatrics, †Gynecology and Obstetrics, and ‡Psychiatry, Sint Lucas Andreas Hospital, VU University Medical Center, Amsterdam, the Netherlands.

出版信息

J Clin Psychopharmacol. 2015 Apr;35(2):163-7. doi: 10.1097/JCP.0000000000000279.

DOI:10.1097/JCP.0000000000000279

PMID:25689290

Abstract

Depression is a common disorder in pregnancy and associated with adverse effects for both mother and neonate. Pharmacological treatment and prevention options include mirtazapine. In a series of 56 cases, we investigated neonatal outcome after intrauterine exposure to mirtazapine and exposure through lactation in the first days postpartum.No increase in any neonatal complication was observed. None of the infants exposed to mirtazapine in the first trimester were born with a major malformation. Of the 54 infants exposed to mirtazapine in the third trimester, 14 were diagnosed with poor neonatal adaptation syndrome (PNAS). This incidence (25.9%) is similar to the incidence of PNAS after intrauterine exposure to other antidepressants. The incidence of PNAS after exposure to mirtazapine was significantly diminished in children who were partially or fully breastfed (18.6% versus 54.5%, P = 0.024).

摘要

抑郁症是孕期常见的疾病，对母亲和新生儿均有不良影响。药物治疗和预防选择包括米氮平。在一系列56例病例中，我们调查了宫内暴露于米氮平以及产后头几天通过哺乳暴露后的新生儿结局。未观察到任何新生儿并发症增加。孕早期暴露于米氮平的婴儿均未出现严重畸形。在孕晚期暴露于米氮平的54例婴儿中，14例被诊断为新生儿适应不良综合征（PNAS）。这一发生率（25.9%）与宫内暴露于其他抗抑郁药后的PNAS发生率相似。部分或完全母乳喂养的儿童在暴露于米氮平后PNAS的发生率显著降低（18.6%对54.5%，P = 0.024）。