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Effects of exposure to
selective serotonin reuptake inhibitors during pregnancy on serotonergic
symptoms in newborns and cord blood monoamine and prolactin
concentrations.
Laine K, Heikkinen T, Ekblad U,
Kero P.
Department of Pharmacology and Clinical Pharmacology,
University of Turku and Turku University Central Hospital, Turku,
Finland. karlai@utu.fi
BACKGROUND: Selective serotonin reuptake
inhibitors (SSRIs) have gained wide acceptance in the treatment of
mental disorders in pregnant women, but there seems to be an increased
risk for neonatal adaptation problems after exposure to SSRIs in late
pregnancy. We aimed to investigate the perinatal sequelae of infants
exposed to SSRIs during their fetal life and the relationship of these
symptoms to the cord blood monoamine and prolactin concentrations.
METHODS: We conducted a prospective, controlled, follow-up study with 20
mothers taking 20 to 40 mg/d of either citalopram or fluoxetine for
depression (n = 10) or panic disorder (n = 10) and their infants and 20
matched controls not receiving psychotropic medication for confounding
obstetric characteristics. Maternal cord blood and infant citalopram,
fluoxetine, and norfluoxetine, cord blood monoamine and metabolite, and
prolactin concentrations were measured. The newborns underwent standard
clinical examination and specific assessment of serotonergic symptoms
during the first 4 days of life and at the ages of 2 weeks and 2 months.
RESULTS: There was a statistically significant (P =.008, V = 15, n = 20
for both groups), 4-fold difference in the serotonergic symptom score
during the first 4 days of life between the SSRI group and the control
group. The SSRI-exposed infants had significantly lower cord blood
5-hydroxyindoleacetic acid (5-HIAA) concentrations (P =.02, t31 = 2.57)
compared with the control group. A significant inverse correlation (rs =
-0.66, P =.007, n = 15) was seen between the serotonergic symptom score
and the umbilical vein 5-HIAA concentrations in the SSRI-exposed but not
the control infants. CONCLUSIONS: Infants exposed to SSRIs during late
pregnancy are at increased risk for serotonergic central nervous system
adverse effects, and the severity of these symptoms is significantly
related to cord blood 5-HIAA levels.
PMID: 12860776 [PubMed -
indexed for MEDLINE]
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