Article

On categorizing gestational, birth, and neonatal complications following late pregnancy exposure to antidepressants: The prenatal antidepressant exposure syndrome

Mental Health Center, Salerno, Italy.
CNS spectrums (Impact Factor: 1.3). 03/2010; 15(3):167-85.
Source: PubMed

ABSTRACT Late in utero exposure to antidepressants has been suspected of adversely impacting pregnancy outcome and compromising neonatal adaptation. Hence, the necessity exists to analyze published information on antidepressant use during late pregnancy to individuate potential recurrent patterns of iatrogenic complications.
Computerized searches on MEDLINE, PsycINFO, ENBASE, and Cochrane Library through February 10, 2010 were performed for selecting literature information and investigating the safety of antidepressants when used during late pregnancy.
Antidepressant treatment during late pregnancy may increase the rates of poor pregnancy outcome and neonatal withdrawal/toxic reactions.
Because both gestational complications and neonatal adverse events acknowledge the same etiology, the author suggests including such iatrogenic events under the definition of prenatal antidepressant exposure syndrome, in order to increase clinicians' awareness about the spectrum of risks which may concern the mother-infant pair when antidepressant treatment is deemed indispensable during late pregnancy.

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Available from: Salvatore Gentile, Jul 24, 2015
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    • ", 2014b ) . Despite the good safety profile of SSRIs in early pregnancy , some concerns have been raised for new - borns exposed to such drugs in late pregnancy , as some gestational and perinatal complications ( PCs ) have been reported in a number of studies and meta - analyses ( Gentile , 2010 ; El Marroun et al . , 2012 ; Grigoriadis et al . "
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    ABSTRACT: The present study provides a comprehensive review of the existing literature on the safety of serotonin-noradrenaline reuptake inhibitors (SNRIs) in pregnancy and lactation. Studies published in English, reporting the use of SNRIs in pregnant and/or breastfeeding women, were identified by searching MEDLINE/Pubmed, PsycINFO, and EMBASE. Twenty-nine studies were included in the review. Altogether, the initial evidence coming from the reviewed studies suggests a lack of association between SNRIs and an increased risk of major congenital malformations. Conversely, exposure to SNRIs seems to be significantly associated with an increased risk of some perinatal complications. No neonatal adverse events emerged, so far, in the few studies concerning the safety of SNRIs during breastfeeding. Available data suggest that venlafaxine is relatively safe during pregnancy, in particular as far as major malformations are concerned, whereas considering the small number of studies published, no definitive conclusions can be drawn on its safety during breastfeeding. Because of the few studies so far published, the safety of duloxetine during pregnancy and breastfeeding remains to be well established. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
    Human Psychopharmacology Clinical and Experimental 03/2015; 30(3). DOI:10.1002/hup.2473 · 1.85 Impact Factor
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    • ", 2014b ) . Despite the good safety profile of SSRIs in early pregnancy , some concerns have been raised for new - borns exposed to such drugs in late pregnancy , as some gestational and perinatal complications ( PCs ) have been reported in a number of studies and meta - analyses ( Gentile , 2010 ; El Marroun et al . , 2012 ; Grigoriadis et al . "
    [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVE: The present study provides a comprehensive review of the existing literature on the safety of serotonin-noradrenaline reuptake inhibitors (SNRIs) in pregnancy and lactation. METHODS: Studies published in English, reporting the use of SNRIs in pregnant and/or breastfeeding women, were identified by searching MEDLINE/Pubmed, PsycINFO, and EMBASE. RESULTS: Twenty-nine studies were included in the review. Altogether, the initial evidence coming from the reviewed studies suggests a lack of association between SNRIs and an increased risk of major congenital malformations. Conversely, exposure to SNRIs seems to be significantly associated with an increased risk of some perinatal complications. No neonatal adverse events emerged, so far, in the few studies concerning the safety of SNRIs during breastfeeding. CONCLUSIONS: Available data suggest that venlafaxine is relatively safe during pregnancy, in particular as far as major malformations are concerned, whereas considering the small number of studies published, no definitive conclusions can be drawn on its safety during breastfeeding. Because of the few studies so far published, the safety of duloxetine during pregnancy and breastfeeding remains to be well established
    Human Psychopharmacology Clinical and Experimental 03/2015; DOI:10.1002/hup.2473. · 1.85 Impact Factor
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    • "During pregnancy, MDD may have several disruptive consequences: depressed women do not seek early prenatal care and are more likely to show other negative behaviours including inadequate diet, use of tobacco, alcohol, and other harmful substances, as well as self-harm or suicide (Yonkers et al., 2009). On the other hand, prenatal exposure to maternal depression has been found to affect infant temperament and to predispose the newborn to a subsequent development of psychiatric disorders (Davis et al., 2007; Gentile, 2010; Davalos et al., 2012). Furthermore, if untreated, MDD can have relevant negative maternal and neonatal consequences, including increased risk for miscarriage, pre-eclampsia, pattern delivery, and low birth weight (Grote et al., 2010). "
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    ABSTRACT: OBJECTIVE: Escitalopram (ESC) is considered one of the most effective selective serotonin reuptake inhibitors for the treatment of major depression. However, little is known on its potential risk of inducing major malformations (MMs) and perinatal complications (PCs). Hence, aim of the present study is to provide a comprehensive review of the available literature on the safety profile of ESC during pregnancy and breastfeeding. METHODS: MEDLINE and PubMed databases were searched for English language articles by using the following keywords: escitalopram, selective serotonin reuptake inhibitors, major malformations, perinatal complications, pregnancy, and breastfeeding. RESULTS: Although some cases of MMs have been reported after maternal exposure to ESC during early pregnancy, the rate of these adverse events is substantially in the range of those reported in unexposed women. On the contrary, exposure to ESC seems to be significantly associated with some PCs. No adverse effects have been reported in the few studies evaluating its safety during breastfeeding. CONCLUSIONS: The available data seem to support the notion that ESC might be considered safe during pregnancy, in particular as far as MMs is concerned. However, similar to other selective serotonin reuptake inhibitors, it could be associated with an increased risk of PCs. Given the paucity of the studies published so far, no definitive conclusions can be drawn on its safety profile during breastfeeding. Copyright © 2012 John Wiley & Sons, Ltd.
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