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Risk factors for poor neonatal adaptation after exposure to antidepressants in utero

Noera Kieviet1, Chris Hoppenbrouwers, Koert M Dolman

  • 1Department of Paediatrics, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands.

Acta Paediatrica (Oslo, Norway : 1992)
|January 7, 2015
PubMed

Insights

Infants exposed to antidepressants in the womb face higher risks of poor neonatal adaptation (PNA). Formula feeding and selective serotonin reuptake inhibitors (SSRIs) increased PNA risk, while dosage did not significantly impact outcomes.

Area of Science:

  • Neonatal Health
  • Pharmacology
  • Obstetrics

Background:

  • Infants exposed to antidepressants during gestation are susceptible to poor neonatal adaptation (PNA).
  • Identifying risk factors for PNA is crucial for optimizing neonatal outcomes.
  • Prenatal antidepressant exposure necessitates careful evaluation of neonatal health post-delivery.

Purpose of the Study:

  • To identify risk factors associated with poor neonatal adaptation (PNA) in infants exposed to antidepressants in utero.
  • To investigate the impact of feeding type, antidepressant class and dosage, and maternal factors on PNA.
  • To provide evidence-based insights for managing neonatal outcomes in exposed infants.

Main Methods:

  • A cohort study analyzed data from 247 infants exposed to antidepressants during the third trimester.
  • Poor neonatal adaptation (PNA) was defined by Finnegan scores of four or more.
  • Risk factors examined included feeding method, antidepressant type/dosage, prematurity, and maternal smoking, anxiety, or depression.

Main Results:

  • 64% of infants (157/247) developed PNA.
  • Formula feeding showed a significantly higher risk of PNA compared to breastfeeding (OR 3.16, p=0.003).
  • Selective serotonin reuptake inhibitors (SSRIs) were associated with increased PNA risk versus serotonin and noradrenaline reuptake inhibitors (OR 2.52, p=0.04).

Conclusions:

  • Formula feeding and exposure to SSRIs are linked to increased PNA risk.
  • Antidepressant dosage did not significantly influence the risk of PNA.
  • These findings highlight the importance of feeding strategies and antidepressant choice in neonatal care.
Abstract

Keywords:
AntidepressantsNeonatal abstinencePoor neonatal adaptationSerotonin reuptake inhibitors

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