• Online Features  This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (75)  • Contact me when this article is cited  Related Content  • Related letters  • Similar articles in this journal  Topic Collections  • Pediatrics  • Neonatology and Infant Care  • Psychiatry  • Depression  • Psychopharmacology  • Drug Therapy  • Adverse Effects  • Alert me on articles by topic  Social Bookmarking   What's this?

Rachel Levinson-Castiel, MD; Paul Merlob, MD; Nehama Linder, MD; Lea Sirota, MD; Gil Klinger, MD

Arch Pediatr Adolesc Med. 2006;160:173-176.

Objective  To compare the prevalence and clinical characteristics of neonatal abstinence syndrome in neonates exposed and not exposed to selective serotonin reuptake inhibitors (SSRIs) in utero.

Design  Cohort study.

Setting  Tertiary care center.

Patients  One hundred twenty term infants, of whom 60 had prolonged in utero exposure to SSRIs, including paroxetine hydrochloride, fluoxetine, citalopram hydrobromide, sertraline hydrochloride, and venlafaxine hydrochloride.

Main Outcome Measures  Neonatal abstinence syndrome was assessed with the Finnegan score as follows: score of 8 or above, severe; score of 4 to 7, mild; and score of 0 to 3, normal. All infants were followed up with a standardized protocol that included repeated Finnegan score assessments and cardiorespiratory monitoring until normalization of the Finnegan score.

Results  Of the 60 neonates exposed to SSRIs in utero, 8 showed severe and 10 showed mild symptoms of a neonatal abstinence syndrome. All nonexposed neonates had a normal Finnegan score. In neonates who developed severe symptoms, the maximum mean daily Finnegan scores were recorded within 2 days after birth, although maximum individual scores were recorded as long as 4 days after birth.

Conclusions  Neonatal abstinence syndrome occurs in 30% of neonates exposed to SSRIs in utero. These neonates should be monitored for at least 48 hours after birth. The long-term effects of prolonged exposure to SSRIs, particularly in neonates who develop severe symptoms, have yet to be determined.

Author Affiliations: Neonatal Intensive Care Unit, Schneider Children's Medical Center of Israel, Petah Tiqwa (Drs Levinson-Castiel, Merlob, Linder, Sirota, and Klinger); Department of Neonatology, Rabin Medical Center, Petah Tiqwa (Drs Merlob, Linder, Sirota, and Klinger); and Sackler School of Medicine, Tel Aviv University, (Drs Merlob, Linder, Sirota, and Klinger), Tel Aviv, Israel.

CiteULike    Connotea    Delicious    Digg    Facebook    Reddit    Technorati    Twitter     What's this?

RELATED LETTERS

Neonatal Adverse Reactions After In Utero Exposure to Selective Serotonin Reuptake Inhibitors: Still Controversial
Louise Beaulac-Baillargeon and Nina Boucher
Arch Pediatr Adolesc Med. 2006;160(8):855-856.
EXTRACT | FULL TEXT  

Neonatal Adverse Reactions After In Utero Exposure to Selective Serotonin Reuptake Inhibitors: Still Controversial—Reply
Gil Klinger, Rachel Levinson-Castiel, and Paul Merlob
Arch Pediatr Adolesc Med. 2006;160(8):856.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Maternal use of SSRIs, SNRIs and NaSSAs: practical recommendations during pregnancy and lactation
Sie et al.
Arch. Dis. Child. Fetal Neonatal Ed. 2011;0:adc.2011.214239v1-fetalneonatal214239.
ABSTRACT | FULL TEXT  

Antidepressants in Pregnancy: a Systematic Review
Udechuku et al.
Aust N Z J Psychiatry 2010;44:978-996.
ABSTRACT | FULL TEXT  

Use of Duloxetine in Pregnancy and Lactation
Briggs et al.
The Annals of Pharmacotherapy 2009;43:1898-1902.
ABSTRACT | FULL TEXT  

Serotonin Discontinuation Syndrome Following in Utero Exposure to Antidepressant Medication: Prospective Controlled Study
Galbally et al.
Aust N Z J Psychiatry 2009;43:846-854.
ABSTRACT | FULL TEXT  

Effects of timing and duration of gestational exposure to serotonin reuptake inhibitor antidepressants: population-based study
Oberlander et al.
Br. J. Psychiatry 2008;192:338-343.
ABSTRACT | FULL TEXT  

Prescribing antidepressants to pregnant women: What is a family physician to do?
Einarson and Koren
cfp 2007;53:1412-1414.
FULL TEXT  

Prescrire des antidepresseurs aux femmes enceintes: Que doivent faire les medecins de famille?
Einarson and Koren
cfp 2007;53:1423-1425.
FULL TEXT  

Safety of selective serotonin reuptake inhibitors in pregnancy
Donnelly and Paton
The Psychiatrist 2007;31:183-186.
ABSTRACT | FULL TEXT  

Effects of Selective Serotonin Reuptake Inhibitors and Venlafaxine During Pregnancy in Term and Preterm Neonates
Ferreira et al.
Pediatrics 2007;119:52-59.
ABSTRACT | FULL TEXT  

Neonatal Adverse Reactions After In Utero Exposure to Selective Serotonin Reuptake Inhibitors: Still Controversial--Reply
Klinger et al.
Arch Pediatr Adolesc Med 2006;160:856-856.
FULL TEXT  

Neonatal Adverse Reactions After In Utero Exposure to Selective Serotonin Reuptake Inhibitors: Still Controversial
Beaulac-Baillargeon and Boucher
Arch Pediatr Adolesc Med 2006;160:855-856.
FULL TEXT  

SSRI-Exposed Babies: Monitor Them for at Least 48 Hours
JWatch Psychiatry 2006;2006:10-10.
FULL TEXT  

SSRI Withdrawal Syndrome in Term Newborns
Aldous
AAP Grand Rounds 2006;15:72-73.
FULL TEXT  

JOURNAL WATCH PEDIATRICS & ADOLESCENT MEDICINE
Arch. Dis. Child. 2006;91:539-540.
FULL TEXT  

SSRI-Exposed Babies: Monitor Them for at Least 48 Hours
JWatch Women's Health 2006;2006:7-7.
FULL TEXT  

Is Prenatal SSRI Exposure Harmful to Newborns?
JWatch Pediatrics 2006;2006:1-1.
FULL TEXT  

SSRI Exposure in Utero -- Harmful to Newborns
JWatch General 2006;2006:5-5.
FULL TEXT