Hurault-Delarue Caroline, Damase-Michel Christine, Finotto Laurent, Guitard Claudine, Vayssière Christophe, Montastruc Jean-Louis, Montastruc François, Lacroix Isabelle
Service de Pharmacologie Clinique, CHU de Toulouse, Inserm 1027, Université de Toulouse, 37 allées Jules Guesde, 31000, Toulouse, France.
Caisse Primaire d'Assurance Maladie de la Haute-Garonne, 3 Boulevard du Professeur Léopold Escande, 31500, Toulouse, France.
Fundam Clin Pharmacol. 2016 Oct;30(5):476-82. doi: 10.1111/fcp.12209. Epub 2016 Aug 5.
Little is known about neurodevelopment of children exposed to psychotropic drugs during pregnancy. The purpose of this study was to evaluate the effects of prenatal exposure to psychotropic drugs on psychomotor development in children. This observational study used the EFEMERIS database. The database records the drugs prescribed and delivered during pregnancy and the resulting outcomes. Neurodevelopment at nine and 24 months of children born to women exposed to psychotropic drugs (anxiolytics, antidepressants, neuroleptics and anti-epileptics) during the second and/or third trimesters of pregnancy was compared to children who were not exposed to these drugs. Psychomotor development of 493 children (1.5%) exposed to psychotropic drugs during pregnancy was compared to 32 303 unexposed children. Exposure to psychotropic drugs during pregnancy was associated with an increased risk of abnormal motor development at 9 months (OR = 1.3 [1.1-2.2]) and abnormal motor and mental development at 24 months (OR = 4.8 [2.1-11.0] and OR = 2.3 [1.05-4.9]). Increased risk was observed in children born to women exposed to anti-epileptic drugs, neuroleptics or antidepressants during pregnancy. This study found a higher rate of deviation from the normal developmental milestones in children born to women exposed to psychotropic drugs during pregnancy and more particularly antidepressants, neuroleptics and anti-epileptics.
关于孕期接触精神药物的儿童的神经发育情况，人们所知甚少。本研究的目的是评估产前接触精神药物对儿童心理运动发育的影响。这项观察性研究使用了EFEMERIS数据库。该数据库记录了孕期开具和使用的药物及其产生的结果。将孕期第二和/或第三阶段接触精神药物（抗焦虑药、抗抑郁药、抗精神病药和抗癫痫药）的女性所生儿童在9个月和24个月时的神经发育情况与未接触这些药物的儿童进行比较。将493名（1.5%）孕期接触精神药物的儿童的心理运动发育情况与32303名未接触药物的儿童进行比较。孕期接触精神药物与9个月时运动发育异常风险增加（OR = 1.3 [1.1 - 2.2]）以及24个月时运动和智力发育异常风险增加（OR = 4.8 [2.1 - 11.0]和OR = 2.3 [1.05 - 4.9]）相关。在孕期接触抗癫痫药、抗精神病药或抗抑郁药的女性所生儿童中观察到风险增加。本研究发现，孕期接触精神药物尤其是抗抑郁药、抗精神病药和抗癫痫药的女性所生儿童，其偏离正常发育里程碑的比例更高。
