Department of Neurology and Psychology, Shenzhen Traditional Chinese Medicine Hospital, The Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China.
Department of Health Sciences, University of Florence, Florence, Italy.
Psychother Psychosom. 2021;90(5):299-307. doi: 10.1159/000516031. Epub 2021 May 10.
A clear picture of neonatal withdrawal signs due to in utero selective serotonin reuptake inhibitor (SSRI) exposure and its consequences is still missing.
A systematic review and a meta-analysis were performed to provide an overview of neonatal withdrawal signs following late in utero exposure to SSRIs and to quantify the corresponding risks.
MEDLINE, Web of Science, and Embase were searched from inception to January 2021. The Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines were followed. English-language observational studies reporting on acute postpartum outcomes following late in utero exposure to SSRIs or SSRIs/venlafaxine were evaluated.
Of 2,269 citations reviewed, 79 studies were assessed for eligibility; 13 were included in the qualitative analysis of the literature, which allowed us to identify 26 signs. A meta-analysis was run separately for studies on SSRI exposure (n = 3) and those on SSRI/venlafaxine exposure (n = 6). Hypoglycemia was identified as a withdrawal sign based on the SSRI studies. Tremors, hypotonia, tachycardia, rapid breathing, respiratory distress, and hypertonia were identified as withdrawal signs based on the SSRI/venlafaxine studies.
The present work provides a framework for the identification of neonatal SSRI withdrawal syndrome. Tapering and discontinuation of antidepressant drugs before and during the early phase of pregnancy are worth attempting to prevent the occurrence of this syndrome.
由于胎儿期选择性 5-羟色胺再摄取抑制剂（SSRI）暴露导致的新生儿戒断症状及其后果仍然不清楚。
进行系统评价和荟萃分析，以提供胎儿期晚期暴露于 SSRIs 后新生儿戒断症状的概述，并量化相应的风险。
从创建到 2021 年 1 月，对 MEDLINE、Web of Science 和 Embase 进行了搜索。遵循观察性研究荟萃分析（MOOSE）指南。评估了报告胎儿期晚期暴露于 SSRIs 或 SSRIs/文拉法辛后急性产后结局的英语观察性研究。
在审查的 2269 篇引用中，有 79 项研究符合纳入标准；13 项研究被纳入文献的定性分析，这使我们能够确定 26 种症状。分别对 SSRI 暴露研究（n=3）和 SSRI/文拉法辛暴露研究（n=6）进行荟萃分析。低血糖被确定为基于 SSRI 研究的戒断症状。震颤、肌张力低下、心动过速、呼吸急促、呼吸困难和高张力被确定为基于 SSRI/文拉法辛研究的戒断症状。
本工作为识别新生儿 SSRI 戒断综合征提供了框架。在妊娠早期之前和期间尝试逐渐减少和停止抗抑郁药物可能有助于预防这种综合征的发生。
