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妊娠期抗抑郁药暴露与儿童感觉运动和视空间发育

Antidepressant exposure in pregnancy and child sensorimotor and visuospatial development.

机构信息

Psychology, Murdoch University, Australia; School of Medicine, University of Notre Dame, Australia; King Edward Memorial Hospital, Australia.

Psychology, Murdoch University, Australia; School of Medicine, University of Notre Dame, Australia.

出版信息

J Psychiatr Res. 2021 Nov;143:485-491. doi: 10.1016/j.jpsychires.2020.11.035. Epub 2020 Nov 25.

Abstract

Motor development underlies many aspects of education and learning. There has been uncertainty about the impact of exposure of antidepressant medication in pregnancy on child motor outcomes. This paper examines whether exposure to antidepressants in utero increases the risk of poorer motor development in two areas: sensorimotor and visuospatial processing. Data were obtained from 195 women and children across 3 groups: women with untreated depression in pregnancy, women treated with antidepressants and control women. Data were collected across pregnancy, postpartum and until 4 years for mother and child. Maternal depression was established at baseline with the Structured Clinical Interview for DSM-IV. Antidepressant exposure, including type, dose and timing, was measured through repeated self-report across pregnancy and the postpartum, medical records at delivery and in cord blood samples collected at delivery. Child sensorimotor and visuospatial outcomes were assessed at 4 years of age with four subtests from the NEPSY-II. Our study found for sensorimotor development, visuomotor precision completion time was associated with better performance for antidepressant-exposed children compared to those with mothers with untreated depression. Yet another measure of sensorimotor development, motor manual sequences, was poorer in those exposed to antidepressants. One subtest for visuospatial processing, block construction, was associated with poorer performance in antidepressant-exposed children who had poor neonatal adaptation and those exposed to a higher dose of antidepressant. These findings suggest an inconsistent association between sensorimotor development and antidepressant use in pregnancy. However, the findings for visuospatial processing would support further exploration of antidepressant associated poor neonatal adaption and later motor development.

摘要

运动发育是教育和学习的多个方面的基础。对于在怀孕期间暴露于抗抑郁药物是否会对儿童的运动结果产生影响,一直存在不确定性。本文研究了在子宫内暴露于抗抑郁药是否会增加两个方面的较差运动发育的风险:感觉运动和视空间处理。数据来自 195 名妇女和儿童的 3 个组:怀孕期间未经治疗的抑郁症妇女,接受抗抑郁药治疗的妇女和对照组妇女。数据是在整个怀孕期间,产后和儿童 4 岁时收集的。在基线时使用 DSM-IV 结构化临床访谈确定了母亲的抑郁情况。抗抑郁药暴露(包括类型,剂量和时间)通过在整个怀孕期间和产后以及分娩时的医疗记录以及分娩时采集的脐带血样本来反复进行自我报告进行测量。在 4 岁时,使用 NEPSY-II 的四个子测试评估儿童的感觉运动和视空间发育。我们的研究发现,对于感觉运动发育,视动精确完成时间与接受抗抑郁药治疗的儿童的表现较好相关,而与未经治疗的母亲的儿童相比。另一个感觉运动发育的指标,运动手动序列,在暴露于抗抑郁药的儿童中较差。视空间处理的一个子测试,积木构造,与新生儿适应不良和暴露于较高剂量抗抑郁药的抗抑郁药暴露儿童的表现较差相关。这些发现表明感觉运动发育与怀孕期间抗抑郁药的使用之间存在不一致的关联。但是,视空间处理的发现将支持进一步探索抗抑郁药与新生儿适应不良和后期运动发育有关的发现。

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