妊娠期选择性血清素再吸收抑制剂 (SSRI) 治疗与新生儿甲状腺查之间的关联:一项大型队列研究
Orian Raviv1,2, Yael Lebenthal1,2, Michal Yackobovitch-Gavan3
1Institute of Pediatric Endocrinology, Dana Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 6423906, Tel Aviv, Israel.
BMC pediatrics
|January 29, 2025
概括
怀孕期间选择性血清素再吸收抑制剂 (SSRI) 治疗没有直接影响新生儿甲状腺功能. 然而,其他孕产妇和分娩因素可能会影响婴儿甲状腺激素水平.
科学领域:
- 围产儿医学 围产儿医学
- 新生儿内分泌学 新生儿内分泌学
- 生殖精神病学是一种精神病学.
背景情况:
- 选择性血清素再吸收抑制剂 (SSRI) 通常用于生育年龄妇女的抑郁和焦虑.
- 妊娠期SSRI暴露对新生儿甲状腺功能的影响尚未得到充分证实.
- 这项研究调查了孕妇在怀孕期间使用SSRI对新生儿甲状腺激素水平的影响.
研究的目的:
- 评估产前SSRI暴露与新生儿甲状腺功能之间的关联.
- 确定可能影响新生儿甲状腺激素水平的孕产妇和产周因素.
- 分析国家新生儿查 (NBS) 计划和相关电子医疗记录的数据.
主要方法:
- 从2011年到2022年,对10万多只母婴双进行了观察性研究.
- 使用了以色列NBS计划的甲状腺数据集 (总甲状腺素-TT4) 和链接的电子医疗记录.
- 采用多变量线性回归来分析TT4水平,不包括先前存在甲状腺疾病的母亲.
主要成果:
- 2.2%的母亲在怀孕期间接受了SSRI治疗.
- 接受SSRI治疗的母亲年龄较大,妊娠前BMI较高,剖腹产次数更多.
- 出生于暴露于SSRI的母亲的婴儿的出生体重z分数较低,妊娠年龄较小的比例更高.
- 接受SSRI治疗并不是新生儿TT4水平的显著预测因素 (p=0.497).
结论:
- 妊娠期的SSRI治疗似乎不会直接影响新生儿的下丘脑-垂体-甲状腺轴适应.
- 母亲年龄,怀孕前的BMI和分娩特征可能会影响新生儿甲状腺功能.
- 需要进一步的研究才能充分理解影响新生儿甲状腺健康的因素的复杂相互作用.
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