Tijdschrift voor kindergeneeskunde

, Volume 75, Issue 4, pp 159–164 | Cite as

Gevolgen ssri-gebruik zwangeren bij de pasgeborene in de eerste 48 uur post partum

Artikelen

Samenvatting

Het gebruik van ssri's (specifieke serotonineheropnameremmers) gedurende het derde trimester van de zwangerschap komt regelmatig voor en kan bij de pasgeborene leiden tot onttrekkingsverschijnselen. Dit onderzoek beschrijft het klachtenpatroon dat bij neonaten kan optreden wanneer de moeder tijdens de zwangerschap ssri's gebruikt. Bij een hoog percentage (62%) van in totaal 29 geobserveerde pasgeborenen werden in de eerste 48 uur post partum afwijkingen passend bij onttrekkingsverschijnselen geconstateerd. Bij 17% van de kinderen was daarbij een observatieperiode van langer dan 48 uur noodzakelijk. 45% van de bevallingen was niet fysiologisch. Slechts zes kinderen (21%) werden én fysiologisch geboren én hadden geen onttrekkingsverschijnselen. Wij adviseren de partus poliklinisch te laten plaatsvinden en de pasgeborene ten minste 48 uur te observeren bij maternaal ssri-gebruik in het laatste trimester van de zwangerschap.

Abstract Summary

Maternal use of ssris (selective serotonin reuptake inhibitors) during the third trimester of pregnancy may lead to neonatal withdrawal symptoms. This study describes the effects of withdrawal on the newborn. A high percentage (62%) of 29 observed newborns showed withdrawal symptoms in the first 48 hours post partum. 17% needed an observational period longer than 48 hours. 45% of births in the study was not physiological. Only six newborns (21%) were physiologically delivered and without any symptoms. We advise clinical delivery and post partum monitoring of the newborn for at least 48 hours after maternal use of ssris during the third trimester of pregnancy.

Literatuur

  1. Lattimore KA, Donn SM, Kaciroti N, et al. Selective serotonin reuptake inhibitor (SSRI) use during pregnancy and effects on the fetus and newborn: a meta-analysis. J Perinatol. 2005;25(9):595-604.CrossRefPubMedGoogle Scholar
  2. Ferreira E, Carceller AM, Agogue C, et al. Effects of selective serotonin reuptake inhibitors and venlafaxine during pregnancy in term and preterm neonates. Pediatrics. 2007;119(1):52-9.CrossRefPubMedGoogle Scholar
  3. Sanz EJ, De-las-Cuevas C, Kiuru A, et al. Selective serotonin reuptake inhibitors in pregnant women and neonatal withdrawal syndrome: a database analysis. Lancet. 2005;365(9458): 482-7.PubMedGoogle Scholar
  4. Oberlander TF, Warburton W, Misri S, et al. Neonatal outcomes after prenatal exposure to selective serotonin reuptake inhibitor antidepressants and maternal depression using population-based linked health data. Arch Gen Psychiatry. 2006;63 (8):898-906.CrossRefPubMedGoogle Scholar
  5. Nordeng H, Spigset O. Treatment with selective serotonin reuptake inhibitors in the third trimester of pregnancy: effects on the infant [review]. Drug Saf. 2005;28(7):565-81.CrossRefPubMedGoogle Scholar
  6. Moses-Kolko EL, Bogen D, Perel J, et al. Neonatal signs after late in utero exposure to serotonin reuptake inhibitors: literature review and implications for clinical applications [review]. JAMA. 2005;293(19):2372-83.CrossRefPubMedGoogle Scholar
  7. Nordeng H, Lindemann R, Perminov KV, Reikvam A. Neonatal withdrawal syndrome after in utero exposure to selective serotonin reuptake inhibitors. Acta Paediatr. 2001;90(3):288-91.CrossRefPubMedGoogle Scholar
  8. Moor RA de, Mourad L, Haar J ter, Egberts AC. Onthoudingsverschijnselen bij een neonatus na blootstelling aan venlafaxine tijdens de zwangerschap. Ned Tijdschr Geneeskd. 2003;147(28):1370-2.PubMedGoogle Scholar
  9. Bot P, Semmekrot BA, Stappen J van der. Neonatal effects of exposure to selective serotonin reuptake inhibitors during pregnancy. Arch Dis Child Fetal Neonatal Ed. 2006;91(2): F153.CrossRefPubMedGoogle Scholar
  10. Kulin NA, Pastuszak A, Sage SR, et al. Pregnancy outcome following maternal use of the new selective serotonin reuptake inhibitors: a prospective controlled multicenter study. JAMA. 1998;279(8):609-10.CrossRefPubMedGoogle Scholar
  11. Alwan S, Reefhuis J, Rasmussen S, et al. Maternal use of selective serotonin re-uptake inhibitors and risk for birth defects. Birth Defects Res A Clin Mol Teratol. 2005;731:291.Google Scholar
  12. Kallen B, Otterblad Olausson P. Antidepressant drugs during pregnancy and infant congenital heart defect. Reprod Toxicol. 2006;21(3):221-2.CrossRefPubMedGoogle Scholar
  13. Chambers CD, Hernandez-Diaz S, Marter LJ van, et al. Selective serotonin-reuptake inhibitors and risk of persistent pulmonary hypertension of the newborn. N Engl J Med. 2006;354(6): 579-87.CrossRefPubMedGoogle Scholar
  14. Casper RC, Fleisher BE, Lee-Ancajas JC, et al. Follow-up of children of depressed mothers exposed or not exposed to antidepressant drugs during pregnancy. J Pediatr. 2003;142(4):402-8.CrossRefPubMedGoogle Scholar
  15. Nulman I, Rovet J, Stewart DE, et al. Child development following exposure to tricyclic antidepressants or fluoxetine throughout fetal life: a prospective, controlled study. Am J Psychiatry. 2002;159(11):1889-95.CrossRefPubMedGoogle Scholar
  16. Cissoko H, Swortfiguer D, Giraudeau B, et al. Exposition aux antidépresseurs inhibiteurs de la recapture de la sérotonine (IRS) en fin de grossesse: retentissement néonatal. Arch Pediatr. 2005;12(7):1081-4.CrossRefPubMedGoogle Scholar
  17. Stiskal JA, Kulin N, Koren G, et al. Neonatal paroxetine withdrawal syndrome. Arch Dis Child Fetal Neonatal Ed. 2001;84(2):F134-5.CrossRefPubMedGoogle Scholar
  18. Laine K, Heikkinen T, Ekblad U, Kero P. Effects of exposure to selective serotonin reuptake inhibitors during pregnancy on serotonergic symptoms in newborns and cord blood monoamine and prolactin concentrations. Arch Gen Psychiatry. 2003; 60(7):720-6.CrossRefPubMedGoogle Scholar
  19. Levinson-Castiel R, Merlob P, Linder N, et al. Neonatal abstinence syndrome after in utero exposure to selective serotonin reuptake inhibitors in term infants. Arch Pediatr Adolesc Med. 2006;160(2):173-6.CrossRefPubMedGoogle Scholar

Copyright information

© Bohn Stafleu van Loghum 2007

Authors and Affiliations

  1. 1.

Personalised recommendations