Kieviet Noera, de Jong Fokke, Scheele Fedde, Dolman Koert M, Honig Adriaan
Department of Pediatrics, Psychiatry Obstetrics Pediatrics Expert Center OLVG West, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands.
Department of Psychiatry, Psychiatry Obstetrics Pediatrics Expert Center OLVG West, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands.
BMC Pregnancy Childbirth. 2017 Jan 11;17(1):23. doi: 10.1186/s12884-016-1184-5.
Psychiatric disorders and use of selective antidepressants during pregnancy can have negative effects on mother and infant postpartum. This study aimed to provide evidence-based recommendations on observation of antidepressant-exposed mother-infant dyads.
In this observational study, mother-infant dyads were observed for possible consequences of either the maternal psychiatric disorder or fetal exposure to selective antidepressants during pregnancy. These possible complications can lead to medical interventions, including 1. adjustment of antidepressants 2. admission to the psychiatric department 3. additional investigations due to indistinctness about the origin of neonatal symptoms 4. treatment of poor neonatal adaptation and 5. consultation of an external organization for additional care. The type, number and time to medical interventions were analyzed.
In 61% of the 324 included mother-infant dyads one or more intrventions were performed. Adjustment of antidepressants and treatment of poor neonatal adaptation were most prevalent. In 75% of dyads the final intervention was performed within 48 h.
The high prevalence and type of medical interventions requires professional observation of all mother-infant dyads exposed to selective antidepressants. In the absence of specialized home care, hospital admission is indicated whereby an observational period of 48 h seems sufficient for most dyads.
孕期精神疾病及使用选择性抗抑郁药可能对母婴产后产生负面影响。本研究旨在为观察暴露于抗抑郁药的母婴二元组提供循证建议。
在这项观察性研究中，观察母婴二元组，以了解孕期母亲精神疾病或胎儿暴露于选择性抗抑郁药可能产生的后果。这些可能的并发症可能导致医疗干预，包括1. 调整抗抑郁药；2. 入住精神科；3. 因新生儿症状来源不明进行额外检查；4. 治疗新生儿适应不良；5. 咨询外部机构以获得额外护理。分析了医疗干预的类型、数量和时间。
在纳入的324对母婴二元组中，61%进行了一项或多项干预。调整抗抑郁药和治疗新生儿适应不良最为常见。75%的二元组在48小时内进行了最终干预。
医疗干预的高发生率和类型需要对所有暴露于选择性抗抑郁药的母婴二元组进行专业观察。在缺乏专业家庭护理的情况下，建议住院治疗，对大多数二元组而言，48小时的观察期似乎足够。
