Department of Pediatrics, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USA.
Department of Pediatrics, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USA,
Neonatology. 2019;115(4):320-327. doi: 10.1159/000496451. Epub 2019 Mar 5.
Selective serotonin reuptake inhibitors (SSRIs) are antidepressants prescribed in 10% of pregnancies in the USA. We have previously shown in preclinical studies that sertraline exposure impacts cardiomyocyte development, leading to reductions in left ventricular size and cardiac function.
We hypothesized that in utero SSRI exposure will lead to reduced left ventricular dimensions and cardiac function on echocardiography immediately after birth.
Twenty term infants with and 21 term infants without in utero exposure to SSRIs underwent echocardiograms to assess cardiac size and function. The exclusion criteria for infants were prematurity, small or large for gestational age, any respiratory or cardiovascular support needed after birth, and any major congenital malformation.
Infants exposed to in utero SSRIs had significantly reduced right ventricular dimensions in the diastole (controls 1.0 cm [0.86, 1.20], SSRI 0.89 cm [0.730, 1.05], p = 0.03), and left ventricular lengths in the diastole and systole (diastole: controls 3.4 cm [3.25, 3.65], SSRI 3.25 cm [3.10, 3.45], p = 0.03; systole: controls 2.9 cm [2.65, 3.05], SSRI 2.6 cm [2.50, 2.85], p = 0.01). No differences were observed in cardiac function. Importantly, there were no differences in maternal conditions or infant birth weight, body surface area, or gestational age.
Our findings suggest an association between in utero exposure to SSRIs and ventricular size in infants. Given the increasing use of SSRIs during pregnancy and the importance of early life programming on future cardiovascular health, larger studies need to be completed to determine if in utero SSRI exposure impacts ventricular size.
选择性 5-羟色胺再摄取抑制剂（SSRIs）是美国 10%的妊娠患者中开具的抗抑郁药。我们之前在临床前研究中表明，舍曲林暴露会影响心肌细胞的发育，导致左心室大小和心功能降低。
我们假设，在子宫内接触 SSRI 会导致出生后立即进行超声心动图检查时左心室尺寸和心功能降低。
20 名患有和 21 名未暴露于 SSRIs 的足月婴儿接受了超声心动图检查，以评估心脏大小和功能。婴儿的排除标准为早产、小于或大于胎龄、出生后需要任何呼吸或心血管支持，以及任何重大先天性畸形。
暴露于子宫内 SSRIs 的婴儿的右心室舒张末期直径明显减小（对照组 1.0cm[0.86，1.20]，SSRI 0.89cm[0.730，1.05]，p=0.03），舒张末期和收缩末期的左心室长度也明显减小（舒张末期：对照组 3.4cm[3.25，3.65]，SSRI 3.25cm[3.10，3.45]，p=0.03；收缩末期：对照组 2.9cm[2.65，3.05]，SSRI 2.6cm[2.50，2.85]，p=0.01）。心功能没有差异。重要的是，母亲的情况、婴儿的出生体重、体表面积或胎龄均无差异。
我们的发现表明，子宫内接触 SSRIs 与婴儿的心室大小有关。鉴于 SSRIs 在怀孕期间的使用越来越多，以及生命早期编程对未来心血管健康的重要性，需要完成更大规模的研究来确定子宫内 SSRI 暴露是否会影响心室大小。
