选择性 5-羟色胺再摄取抑制剂（SSRIs）在妊娠中的应用：对母亲、胎儿和儿童风险的最新综述。
Selective Serotonin Reuptake Inhibitors (SSRIs) in Pregnancy: An Updated Review on Risks to Mother, Fetus, and Child.
机构信息
Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, 1890 N Revere Court, Suite 5003, Aurora, CO, 80045, USA.
出版信息
Curr Psychiatry Rep. 2022 Nov;24(11):687-695. doi: 10.1007/s11920-022-01372-x. Epub 2022 Oct 1.
Abstract
PURPOSE OF REVIEW
To provide an updated summary and appraisal of work from 2019 to 2022 examining risks of selective serotonin reuptake inhibitor (SSRI) use in pregnancy.
RECENT FINDINGS
Perinatal SSRI exposure does not increase risk of major malformations or gestational diabetes after accounting for underlying maternal illness. SSRIs are associated with small increase in risk of pre-eclampsia, postpartum hemorrhage, preterm delivery, persistent pulmonary hypertension of the newborn, and neonatal intensive care unit admissions, though absolute risk of these outcomes is low. While data suggests no increased risk of neurodevelopmental disorders in offspring, mixed evidence indicates increased risk of adverse cognitive outcomes and affective disorders. Recent evidence suggest low absolute risk of clinically relevant negative outcomes with perinatal SSRI exposure when compared to untreated perinatal depression. However, study design and ability to control for confounding remains an ongoing research challenge, highlighting need for ongoing rigorous study design and analysis.
摘要
目的综述
对 2019 年至 2022 年期间研究选择性 5-羟色胺再摄取抑制剂（SSRIs）在妊娠中使用风险的工作进行更新总结和评估。
最新发现
在考虑到潜在母体疾病后，围产期 SSRI 暴露不会增加重大畸形或妊娠糖尿病的风险。SSRI 与子痫前期、产后出血、早产、新生儿持续性肺动脉高压和新生儿重症监护病房入院的风险略有增加有关，尽管这些结果的绝对风险较低。虽然数据表明 SSRI 暴露不会增加后代神经发育障碍的风险，但混合证据表明认知结果和情感障碍的风险增加。最近的证据表明，与未经治疗的围产期抑郁症相比，围产期 SSRI 暴露的临床相关不良结局的绝对风险较低。然而，研究设计和控制混杂因素的能力仍然是一个持续的研究挑战，这突出表明需要进行持续严格的研究设计和分析。
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