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Maternal selective
serotonin reuptake inhibitor use during pregnancy and newborn
neurobehavior.
Zeskind PS, Stephens
LE.
Department of Pediatrics, Carolinas Medical Center,
Charlotte, North Carolina; and the Department of Pediatrics, University
of North Carolina, Chapel Hill, North Carolina.
The used of
selective serotonin reuptake inhibitors (SSRIs) by depressed parturients
has raised concern over possible teratogenic effects on the fetus. These
drugs readily cross the placental barrier, exposing the fetus to
increased serotonin levels early in development. This prospective study
evaluated infant neurobehavior 14 to 39 hours after birth; all were
normal-birth infants. Half the mothers were taking an SSRI. The users
and nonusers were matched for cigarette smoking, maternal age, and
socioeconomic status. Infants were monitored for behavior, startles, and
tremulousness for 1 hour between feedings. Motor activity and heart rate
variability (HRV) were recorded during a 15-minute sleep period.
Behavioral assessment was based on the Neonatal Behavioral Assessment
Scale. The SSRI-exposed infants had shorter gestational ages. They
exhibited more motor activity and tremulousness than did unexposed
infants and had fewer rhythms in HRV. They also had fewer changes in
behavioral state and fewer such states. Peak behavioral state was lower
in the exposed infants. These infants also had significantly more
rapid-eye-movement sleep and tended to have more spontaneous startles
and sudden arousals. After adjusting for gestational age, the only
significant differences were in tremulousness and measures of state and
sleep organization. Adjusted mean motor activity and spectral peaks in
HRV no longer differed significantly between the SSRI-exposed and
nonexposed infants. These findings do not support the view that using an
SSRI during pregnancy has little effect on the developing fetus. It is
possible that the observed changes in motor activity, startles, and HRV
are mediated by the effects of SSRI exposure on gestational
age.
PMID: 15277875 [PubMed - in process]
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