Published online January 2, 2007
PEDIATRICS Vol. 119 No. 1 January 2007, pp. 52-59 (doi:10.1542/peds.2006-2133)
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ARTICLE

Effects of Selective Serotonin Reuptake Inhibitors and Venlafaxine During Pregnancy in Term and Preterm Neonates

Ema Ferreira, BPharm, MSc, PharmD, FCSHPa,b, Ana Maria Carceller, MD, PhD, FRCPCc,d, Claire Agogué, DPharma, Brigitte Zoé Martin, BPharm, MSca,b, Martin St-André, MD, FRCPCd,e, Diane Francoeur, MD, FRCPCd,f and Anick Bérard, PhDb,g

a Departments of Pharmacy (Centre IMAGe)
c Pediatrics
e Psychiatry
f Obstetrics
g Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada
b Faculties of Pharmacy
d Medicine, Université de Montréal, Montréal, Québec, Canada

OBJECTIVES. Our goals were to (a) describe neonatal behavioral signs in a group of newborns exposed in utero to selective serotonin reuptake inhibitors or venlafaxine at the time of delivery, (b) compare the rate of neonatal behavioral signs, prematurity, and admission to specialized neonatal care between a group of exposed and unexposed newborns, and (c) compare the effects in exposed preterm and term newborns.

PATIENTS AND METHODS. This was a retrospective cohort study including mothers taking selective serotonin reuptake inhibitors or venlafaxine during the third trimester and mothers who were not taking any antidepressants, psychotropic agents, or benzodiazepines at the time of delivery of their newborns. Neonatal behavioral signs included central nervous, respiratory, and digestive systems, as well as hypoglycemia and the need for phototherapy.

RESULTS. Seventy-six mothers taking antidepressants and 90 untreated mothers and their newborns were analyzed. Smoking, alcohol intake, and substance abuse were more frequent among treated mothers. In infants in the exposed group, signs involving the central nervous and the respiratory systems were often observed (63.2% and 40.8%, respectively). These signs appeared during the first day of life, with a median duration of 3 days for exposed newborns. The signs resolved in 75% of cases within 3 to 5 days for term and premature newborns, respectively. All exposed premature newborns presented behavioral manifestations compared with 69.1% of term exposed newborns. Median length of stay was almost 4 times longer for exposed premature newborns than for those who were unexposed (14.5 vs 3.7 days).

CONCLUSIONS. Neonatal behavioral signs were frequently found in exposed newborns, but symptoms were transient and self-limited. Premature infants could be more susceptible to the effects of selective serotonin reuptake inhibitors and venlafaxine.

Key Words: selective serotonin reuptake inhibitors • venlafaxine • pregnancy • neonates • prematurity

Abbreviations: SSRI—selective serotonin reuptake inhibitors • CHU—Centre Hospitalier Universitaire • OR—odds ratio • CI—confidence interval

Accepted Sep 18, 2006.


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