The Relationship Between Maternal Antidepressants and Neonatal Hypoglycemia: A Systematic Review

Area of Science:

• Perinatal Medicine
• Neonatal Health
• Pharmacology

Background:

• Antidepressant medications are frequently prescribed during pregnancy.
• Neonatal hypoglycemia is a significant concern for infants exposed to substances in utero.
• Understanding the risks associated with prenatal antidepressant exposure is crucial for clinical practice.

Purpose of the Study:

• To systematically review current research on the association between intrauterine antidepressant exposure and neonatal hypoglycemia.
• To synthesize evidence regarding the risk of neonatal hypoglycemia with different classes of antidepressants.

Main Methods:

• Systematic literature review of studies published between January 2005 and July 2020.
• Keywords included various antidepressants (SSRIs, SNRIs, TCAs), pregnancy, and neonatal hypoglycemia.
• Analysis of odds ratios/risk ratios from 10 relevant studies.

Main Results:

• Overall, maternal antidepressant use during pregnancy was associated with an increased risk of neonatal hypoglycemia (OR/RR 1.33-1.73).
• Selective serotonin reuptake inhibitors (SSRIs) showed an increased risk (OR/RR 1.30-1.35).
• Serotonin-norepinephrine reuptake inhibitors (SNRIs) and tricyclic antidepressants (TCAs) also demonstrated increased risks (OR/RR 1.42-2.11 and 2.07, respectively), with TCAs potentially posing a slightly higher risk than SSRIs.

Conclusions:

• Prenatal exposure to maternal antidepressants is consistently associated with a higher risk of neonatal hypoglycemia.
• Specific antidepressant classes, such as TCAs, may confer a greater risk compared to others like SSRIs.
• Further research is warranted to elucidate the precise mechanisms and refine risk assessment for neonatal outcomes.