Effects of in-utero exposure to selective serotonin reuptake inhibitors and venlafaxine on term and preterm infants

A.N. Hogue*, M.E. Temple-Cooper, M. Lagzdins, S. Worley, J. Scwersenski, R. Floyd, F. Saker | JNPM 2018;

OBJECTIVE: We hypothesized that in-utero SSRI exposure affects Apgar scores and immediate post-delivery oxygen requirements.
STUDY DESIGN: SSRI in-utero exposure was assessed retrospectively in preterm neonates ≥ 28 weeks gestation and term neonates. Primary outcome was Apgar <7 at five minutes and delivery room oxygen requirements. Secondary endpoints included one-minute Apgar, length of stay, birth weight, and NICU admission.
RESULTS: Fifty-one preterm and 117 term neonates were exposed to a SSRI; mostly to sertraline. Pre-term SSRI-exposed neonates had 4.1 times higher delivery room oxygen requirements. One minute Apgar <7 was 3.5 times higher and NICU admission 5 times higher 95% CI (1.3–19) in SSRI-exposed term neonates. Higher doses of sertraline had associated adverse outcomes.
CONCLUSION: In-utero SSRI exposure was associated with increased neonatal care at birth, differences in Apgar scores compared with controls, and increased NICU admissions. Higher sertraline doses were associated with poorer outcomes.

*Corresponding Author: 

M.E. Temple-Cooper, Department of Pharmacy Services, Hillcrest – Cleveland Clinic, Mayfield Heights, OH, USA. E-mail: mtemple@ccf.org.