母亲抗抑郁药对胎儿无应激试验的影响。

IF 2.7 3区 医学 Q2 PSYCHIATRY
Emily McCauley, Alyssa Thompson, Samantha Gawrys, Jason Benedict, Jonathan Schaffir
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引用次数: 0

摘要

目的:选择性血清素再摄取抑制剂(SSRIs)通常用于治疗妊娠期情绪障碍,尽管有关其对胎儿行为的影响的研究存在矛盾。先前的研究表明,胎儿在妊娠晚期接触这些药物可能会降低胎儿心率变异性。由于可变性的变化可能会影响产前检测的解释,临床医生应该意识到那些可能损害有效检测的药物。方法:采用回顾性观察队列研究,比较妊娠36周暴露于SSRIs的胎儿与未暴露于SSRIs的胎儿的非应激试验(NST)参数。如果受试者有多胎妊娠、胎儿异常包括生长受限、非法使用药物或使用其他精神药物,则排除受试者。对nst进行胎儿基线心率、变异性、反应时间、随时间加速次数和随时间胎动次数的比较。结果:在219名参与者中,12名在他们36周的NST时服用SSRI/SNRI。两组之间在人口统计学或NST适应症方面没有显著差异。在服用SSRI/SNRI的患者中,nst反应性为92%,未服用SSRI/SNRI的患者中为97%。反应时间[8.6 min vs. 12.5 min]、基线心率[142 bpm vs. 139 bpm]和心率变异性[12.1 bpm vs. 11.7 bpm]在两组之间都相似。结论:尽管受样本量、缺乏药理学数据和适应症的潜在混淆的限制,该研究表明SSRI的使用与NST的任何显著变化无关。临床医生应该放心,NST评估仍然是确定使用这些药物的患者胎儿健康的有用手段。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Maternal antidepressant effects on the fetal nonstress test

Purpose

Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for mood disorders in pregnancy, though studies regarding effects on fetal behavior are conflicting. Previous studies have suggested that fetuses exposed to these medications in the third trimester may have decreased fetal heart rate variability. Since changes in variability may affect the interpretation of antenatal testing, clinicians should be aware of those medications that may impair effective testing.

Methods

A retrospective observational cohort study was performed to compare nonstress test (NST) parameters of fetuses exposed to SSRIs with unexposed fetuses at 36 weeks gestation. Subjects were excluded if they had multiple gestations, fetal anomalies including growth restriction, illicit substance use or use of other psychotropic medications. NSTs were compared for fetal baseline heart rate, variability, time to reactivity, number of accelerations over time, and number of fetal movements over time.

Results

Of 219 participants, 12 were taking an SSRI/SNRI at the time of their 36-week NST. There were no significant differences in demographics or indications for NST between groups. NSTs were reactive in 92% of those taking an SSRI/SNRI and in 97% of those not taking an SSRI/SNRI. Time to reactivity [8.6 min vs. 12.5 min], baseline heart rate [142 bpm vs. 139 bpm], and heart rate variability [12.1 bpm vs. 11.7 bpm] were all similar between the two groups.

Conclusion

Though limited by sample size, lack of pharmacologic data and potential confounding by indication, the study suggests SSRI use is not associated with any significant changes in NST. Clinicians should be reassured that NST assessment remains a useful means of determining fetal wellbeing in patients using these medications.

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来源期刊
Archives of Women's Mental Health
Archives of Women's Mental Health 医学-精神病学
CiteScore
8.00
自引率
4.40%
发文量
83
审稿时长
6-12 weeks
期刊介绍: Archives of Women’s Mental Health is the official journal of the International Association for Women''s Mental Health, Marcé Society and the North American Society for Psychosocial Obstetrics and Gynecology (NASPOG). The exchange of knowledge between psychiatrists and obstetrician-gynecologists is one of the major aims of the journal. Its international scope includes psychodynamics, social and biological aspects of all psychiatric and psychosomatic disorders in women. The editors especially welcome interdisciplinary studies, focussing on the interface between psychiatry, psychosomatics, obstetrics and gynecology. Archives of Women’s Mental Health publishes rigorously reviewed research papers, short communications, case reports, review articles, invited editorials, historical perspectives, book reviews, letters to the editor, as well as conference abstracts. Only contributions written in English will be accepted. The journal assists clinicians, teachers and researchers to incorporate knowledge of all aspects of women’s mental health into current and future clinical care and research.
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