Published online September 1, 2008
PEDIATRICS Vol. 122 No. 3 September 2008, pp. e710-e715 (doi:10.1542/peds.2008-0658)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Dubnov-Raz, G.
Right arrow Articles by Finkelstein, Y.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Dubnov-Raz, G.
Right arrow Articles by Finkelstein, Y.
Related Collections
Right arrow Premature & Newborn
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

ARTICLE

Antenatal Use of Selective Serotonin-Reuptake Inhibitors and QT Interval Prolongation in Newborns

Gal Dubnov-Raz, MD, MSca,b, David N. Juurlink, MD, PhDc, Rami Fogelman, MDd, Paul Merlob, MDb, Shinya Ito, MDe, Gideon Koren, MDe and Yaron Finkelstein, MDe,f,g,h

a Department of Pediatrics, Mt Scopus, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
b BELTIS Teratology Information Center, Department of Neonatology, Rabin Medical Center, Petah Tikva, Israel; Department of
d Pediatric Cardiology
f Pediatrics, Schneider Children's Medical Center of Israel, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
c Department of Medicine, Pediatrics, and Health Policy, Management, and Evaluation
e MotheRisk Program, Divisions of Clinical Pharmacology and Toxicology
g Emergency Medicine, Department of Pediatrics, Hospital for Sick Children, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
h Clinical Pharmacology Unit, Division of Emergency Medicine, Children's Hospital, Boston, Boston, Massachusetts

OBJECTIVES. Prolongation of the QT interval is a risk factor for sudden death. Selective serotonin-reuptake inhibitor antidepressants can prolong the QT interval and are widely used by pregnant women. Whether antenatal exposure to selective serotonin-reuptake inhibitor causes QT prolongation in offspring is unknown. The aim of this study was to determine the effect of maternal use of selective serotonin-reuptake inhibitor antidepressants during pregnancy on the QTc interval of the offspring.

METHODS. Between January 2000 and December 2005, we collected data on all of the newborns born at a single tertiary care hospital. Electrocardiograms of infants exposed to selective serotonin-reuptake inhibitor antidepressants in utero were compared with those of healthy control newborns matched on gestational age. The tracings were interpreted by a pediatric cardiologist who was unaware of the drug exposure.

RESULTS. We identified 52 newborns exposed to selective serotonin-reuptake inhibitor antidepressants in the immediate antepartum period and 52 matched control subjects. The mean QTc was significantly longer in the group of newborns exposed to antidepressants as compared with control subjects (409 ± 42 vs 392 ± 29 milliseconds). Five (10%) newborns exposed to selective serotonin-reuptake inhibitor antidepressants had a markedly prolonged QTc interval (>460 milliseconds) compared with none of the unexposed newborns. The longest QTc interval observed among exposed newborns was 543 milliseconds. All of the drug-associated repolarization abnormalities normalized in subsequent electrocardiographic tracings.

CONCLUSIONS. Antepartum use of selective serotonin-reuptake inhibitor antidepressants is associated with QTc interval prolongation in exposed neonates. Additional research using a standardized protocol is needed to determine whether exposure to selective serotonin-reuptake inhibitor antidepressants in late pregnancy is also associated with arrhythmias.

Key Words: pregnancy • antidepressant • adverse drug events • electrocardiography • long-QT syndrome

Abbreviations: SSRI—selective serotonin-reuptake inhibitor • ECG—electrocardiography

Accepted Apr 22, 2008.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?