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Maternal selective
serotonin reuptake inhibitor use during pregnancy and newborn
neurobehavior.
Zeskind PS, Stephens
LE.
Department of Pediatrics, Carolinas Medical Center,
Charlotte, North Carolina 28232, USA.
pzeskind@carolinashealthcare.org
OBJECTIVE: This is a prospective
study of the effects of maternal use of selective serotonin reuptake
inhibitors (SSRIs) during pregnancy on newborn neurobehavioral
integrity, including systematic measures of behavioral state, sleep
organization, motor activity, heart rate variability (HRV),
tremulousness, and startles. METHODS: The sample included 17
SSRI-exposed and 17 nonexposed, full-birth-weight newborn infants who
had no obvious medical problems and were matched on maternal cigarette
use, social class, and maternal age. SSRI exposure was determined by
medical records and maternal self-report during a standard interview.
Behavioral state, startles, and tremulousness were evaluated for 1 hour
between feedings. Automated recordings of motor activity and HRV were
also assessed during a 15-minute subset sleep period. HRV was subjected
to spectral analysis to detect rhythms in autonomic regulation. Exposed
and nonexposed infant groups were compared on measures of
neurobehavioral development both before and after adjustment for
gestational age as a covariate. RESULTS: SSRI-exposed infants had a
shorter mean gestational age; were more motorically active and
tremulous; and showed fewer rhythms in HRV, fewer changes in behavioral
state, fewer different behavioral states, and a lower peak behavioral
state. SSRI-exposed infants also had significantly more rapid eye
movement sleep, which was characterized by longer continuous bouts in
that state and higher numbers of spontaneous startles or sudden
arousals. After effects of gestational age were covaried, significant
differences continued to be found in tremulousness and all measures of
state and sleep organization, but effects on startles, motor activity,
and rhythms in HRV were no longer significant. CONCLUSIONS: Results
provide the first systematic evidence that women who use SSRIs during
pregnancy have healthy, full-birth-weight newborn infants who show
disruptions in a wide range of neurobehavioral outcomes. Effects on
motor activity, startles, and HRV may be mediated through the effects of
SSRI exposure on gestational age. Future research can lead to a better
understanding of the effects of SSRI use during pregnancy and an
improved public health outcome.
PMID: 14754951 [PubMed - indexed
for MEDLINE]
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