Nulman I, Rovet J, Stewart D E, Wolpin J, Gardner H A, Theis J G, Kulin N, Koren G
Motherisk Program, Hospital for Sick Children and University of Toronto, ON, Canada.
N Engl J Med. 1997 Jan 23;336(4):258-62. doi: 10.1056/NEJM199701233360404.
Many women of reproductive age have depression, necessitating therapy with either a tricyclic antidepressant drug or a drug, such as fluoxetine, that inhibits the reuptake of serotonin. Whether these drugs affect fetal neurodevelopment is not known.
We studied the children of 80 mothers who had received a tricyclic antidepressant drug during pregnancy, 55 children whose mothers had received fluoxetine during pregnancy, and 84 children whose mothers had not been exposed during pregnancy to any agent known to affect the fetus adversely. The children's global IQ and language development were assessed between 16 and 86 months of postnatal age by age-appropriate Bayley Scales of Infant Development or the McCarthy Scales of Children's Abilities (for IQ) and the Reynell Developmental Language Scales.
The mean (+/-SD) global IQ scores were 118+/-17 in the children of mothers who received a tricyclic antidepressant drug, 117+/-17 in those whose mothers received fluoxetine, and 115+/-14 in those in the control group. The language scores were similar in all three groups. The results were similar in children exposed to a tricyclic antidepressant drug or fluoxetine during the first trimester and those exposed throughout pregnancy. There were also no significant differences in temperament, mood, arousability, activity level, distractibility, or behavior problems in the three groups of children.
In utero exposure to either tricyclic antidepressant drugs or fluoxetine does not affect global IQ, language development, or behavioral development in preschool children.
许多育龄女性患有抑郁症，需要使用三环类抗抑郁药或如氟西汀这类抑制5-羟色胺再摄取的药物进行治疗。这些药物是否会影响胎儿神经发育尚不清楚。
我们研究了80名在孕期服用过三环类抗抑郁药的母亲的孩子、55名母亲在孕期服用过氟西汀的孩子，以及84名母亲在孕期未接触过任何已知会对胎儿产生不良影响药物的孩子。在出生后16至86个月，通过适合年龄的贝利婴儿发展量表或麦卡锡儿童能力量表（用于智商）以及雷内尔发育性语言量表对孩子的总体智商和语言发育进行评估。
母亲服用三环类抗抑郁药的孩子的平均（±标准差）总体智商分数为118±17，母亲服用氟西汀的孩子为117±17，对照组孩子为115±14。三组孩子的语言分数相似。在孕早期接触三环类抗抑郁药或氟西汀的孩子与整个孕期都接触的孩子结果相似。三组孩子在气质、情绪、唤醒能力、活动水平、注意力分散度或行为问题方面也没有显著差异。
子宫内接触三环类抗抑郁药或氟西汀不会影响学龄前儿童的总体智商、语言发育或行为发育。
