Maalouli Walid M, Hilliard Brian S
Division of Pediatric Hospital Medicine, Department of Pediatrics, Masonic Children's Hospital, University of Minnesota, Minneapolis, MN, USA.
SAGE Open Med Case Rep. 2020 Aug 27;8:2050313X20952981. doi: 10.1177/2050313X20952981. eCollection 2020.
The use of venlafaxine, a selective serotonin and norepinephrine reuptake inhibitor, for the management of depression in women of childbearing age has been on the rise, and there have been multiple case reports in the literature tying venlafaxine in-utero exposure to a form of neonatal encephalopathy presenting as neonatal abstinence syndrome. We present the case of a 5-day-old term infant whose mother was on venlafaxine throughout her pregnancy and presented with hypothermia, poor feeding, and decreased activity level. She subsequently had a negative sepsis workup and required nasogastric tube feedings for 2 weeks with spontaneous recovery and no clinical sequelae post-discharge. This case highlights the non-trivial potential risk of venlafaxine withdrawal in exposed newborns and the need for close observation. We propose a management framework for such situations in affected infants.
文拉法辛是一种选择性5-羟色胺和去甲肾上腺素再摄取抑制剂,其在育龄期女性抑郁症治疗中的应用呈上升趋势,并且文献中有多篇病例报告将子宫内暴露于文拉法辛与一种表现为新生儿戒断综合征的新生儿脑病形式联系起来。我们报告一例5日龄足月儿病例,其母亲在整个孕期都服用文拉法辛,该婴儿出现体温过低、喂养困难和活动水平下降。随后她的败血症检查结果为阴性,需要鼻胃管喂养2周,之后自发恢复,出院后无临床后遗症。该病例突出了暴露新生儿中文拉法辛戒断的潜在重大风险以及密切观察的必要性。我们为此类受影响婴儿的情况提出了一个管理框架。