孕期暴露于抗抑郁药和子女的神经发育障碍
1Department of Clinical Psychopharmacology and Neurotoxicology, National Institute of Mental Health and Neurosciences, Bangalore, India; Department of Psychiatry, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.
The Journal of clinical psychiatry
|December 17, 2025
概括
孕期接触抗抑郁药物可能会使后代患自闭症谱系障碍 (ASD) 和注意力缺陷/多动症障碍 (ADHD) 的风险增加一倍. 然而,经过调整后的分析表明,这种关联可能是由于混因素而不是直接的因果关系.
科学领域:
- 围产阶段精神病学 围产阶段精神病学
- 发育神经科学的发展神经科学.
- 药学流行病学 药学流行病学
背景情况:
- 怀孕期间未经治疗的抑郁症会给母亲和孩子带来风险.
- 用于治疗母亲抑郁症的抗抑郁药可以穿过胎盘,引发对胎儿发育的担忧.
- 神经发育障碍 (NDD),如自闭症谱系障碍 (ASD) 和注意力缺陷/多动症障碍 (ADHD) 是重大的公共卫生问题.
研究的目的:
- 审查关于妊娠期抗抑郁药物暴露和后代NDDs之间的关联的现有研究.
- 批判性地评估证据,专注于ASD和ADHD风险.
- 为了告知临床决策,关于在怀孕期间使用抗抑郁药.
主要方法:
- 两项最近的元分析和三项随后的观察性研究的综述.
- 分析未调整和调整的数据,以评估现实世界与因果风险的对比.
- 检查混因素,包括父母的遗传学,环境和健康.
主要成果:
- 未经调整的分析表明,随着妊娠期的抗抑郁药物暴露,ASD和ADHD的风险增加了一倍.
- 经过调整后的分析显示,这些风险显著减弱,往往失去了统计学意义.
- 根据指示,父母因素和非产周暴露的混进一步削弱了明显的关联.
结论:
- 妊娠期抗抑郁药暴露与NDD之间的关联可能因各种因素而混.
- 不一致的兄弟对分析表明,NDD的发展与家族因素的联系比在子宫中暴露于抗抑郁药更强烈.
- 在与考虑抗抑郁药治疗的孕妇讨论潜在的NDD风险时,共享决策至关重要.
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