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孕妇服用抗抑郁药会增加新生儿患高血压风险

2012/01/17 来源:MSN
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欧洲研究人员发现,孕妇服用广泛使用的抗抑郁药“选择性5-羟色胺再摄取抑制剂”(即SSRI类抗抑郁药)会增加新生儿患持续肺动脉高血压的风险。

欧洲研究人员发现,孕妇服用广泛使用的抗抑郁药“选择性5-羟色胺再摄取抑制剂”(即SSRI类抗抑郁药)会增加新生儿患持续肺动脉高血压的风险。

来自瑞典卡罗琳医学院和其他北欧4国的研究人员在新一期《英国医学杂志》上报告说,他们的研究以1996年至2007年间丹麦、芬兰、冰岛、挪威和瑞典共计超过160万名孕妇及其新生儿为对象。研究结果显示,服用SSRI类药物的孕妇所产婴儿患持续肺动脉高血压的几率为千分之三,比未受此类药物影响的婴儿患这种病的几率高1倍。

新生儿持续肺动脉高血压是一种罕见且十分严重的疾病,会导致新生儿呼吸困难、血液供氧不足,甚至心力衰竭。

研究课题负责人海勒•基勒说,医生在对患抑郁症的孕妇实施治疗时应尽量选择非药物治疗方法,对于需接受SSRI类药物治疗的孕妇,应提前告知风险。

SSRI类药物自上世纪70年代开始研制,迄今已有数十种产品,使用广泛。研究报告指出,抑郁心理在妇女怀孕期间比较常见,超过7%的孕妇患有抑郁症。此外,中度及重度抑郁症患者普遍服用SSRI类抗抑郁药。

 

Selective serotonin reuptake inhibitors during pregnancy and risk of persistent pulmonary hypertension in the newborn: population based cohort study from the five Nordic countries

Helle Kieler, Miia Artama, , Anders Engeland, Örjan Ericsson, Kari Furu, Mika Gissler, Rikke Beck Nielsen, Mette Nørgaard, Olof Stephansson, Unnur Valdimarsdottir, Helga Zoega, Bengt Haglund

Objective To assess whether maternal use of selective serotonin reuptake inhibitors (SSRIs) increases the risk of persistent pulmonary hypertension in the newborn, and whether such an effect might differ between specific SSRIs.

Design Population based cohort study using data from the national health registers.

Setting Denmark, Finland, Iceland, Norway, and Sweden, 1996-2007.

Participants More than 1.6 million infants born after gestational week 33.

Main outcome measures Risks of persistent pulmonary hypertension of the newborn associated with early and late exposure to SSRIs during pregnancy and adjusted for important maternal and pregnancy characteristics. Comparisons were made between infants exposed and not exposed to SSRIs.

Results Around 30 000 women had used SSRIs during pregnancy and 11 014 had been dispensed an SSRI later than gestational week 20. Exposure to SSRIs in late pregnancy was associated with an increased risk of persistent pulmonary hypertension in the newborn: 33 of 11 014 exposed infants (absolute risk 3 per 1000 liveborn infants compared with the background incidence of 1.2 per 1000); adjusted odds ratio 2.1 (95% confidence interval 1.5 to 3.0). The increased risks of persistent pulmonary hypertension in the newborn for each of the specific SSRIs (sertraline, citalopram, paroxetine, and fluoxetine) were of similar magnitude. Filling a prescription with SSRIs before gestational week 8 yielded slightly increased risks: adjusted odds ratio 1.4 (95% confidence interval 1.0 to 2.0).

Conclusions The risk of persistent pulmonary hypertension of the newborn is low, but use of SSRIs in late pregnancy increases that risk more than twofold. The increased risk seems to be a class effect.

文献链接:http://www.bmj.com/content/344/bmj.d8012

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