Advertisement

However, the Israeli researchers add that these symptoms are usually gone within 48 hours and appear to pose no long-term threat to the infant's health.

Another expert noted that stopping antidepressant therapy during pregnancy poses its own risk to the health of a mother and her child.

"At present, probably the effect of not treating the women's clinical depression is a much bigger issue for mothers and their infants," said Dr Tim Oberlander, an associate professor of paediatrics at the University of British Columbia and a developmental paediatrician at Children's & Women's Health Centre of British Columbia, Vancouver, Canada.

How the study was conducted
In the study, published in the February issue of the Archives of Pediatrics & Adolescent Medicine, a team at the Schneider Children's Medical Centre of Israel studied the health of 120 newborns. Sixty of these babies' mothers took an SSRI to treat depression during their pregnancy, while the other 60 mothers did not.

The researchers assessed each infant's behaviour two hours after birth and again at regular intervals to see if they displayed withdrawal symptoms.

Among the 60 infants exposed to SSRIs in the womb, 18 displayed what experts call "neonatal abstinence syndrome." In a minority of cases, this syndrome "may be severe enough to cause seizures," said senior researcher Dr Gil Klinger, a neonatologist at the hospital. Of the 18 cases noted, eight were severe. The most common symptoms were tremors, gastrointestinal problems, an abnormal increase in muscle tone, sleep disturbances and high-pitched cries.

Symptoms subside within 48 hours
However, Klinger added that "signs of neonatal abstinence subside usually within a few days," he added, noting that none of the babies required treatment.

Based on the findings, Klinger advises that "infants born to mothers treated with SSRIs must be observed for a minimum period of 48 hours or longer if signs of a neonatal abstinence syndrome are evident."

Both mothers and their doctors should become aware of the possible effects of SSRIs on newborns, Klinger said. However, he said the findings don't mean women shouldn't take the drugs to ease depressive symptoms.

Not suggesting cessation
"It must be made clear that depression during pregnancy entails risk to the mother and her foetus, thus we are not suggesting cessation of medication," Klinger said.

In view of the widespread use of SSRIs, the risk-benefit ratio for treatment must be considered, Klinger said. "It should also be stressed that although we have demonstrated short-term effects to drug exposure, it is far more important to assess the long-term effects [to infants], and these are yet unknown."

Oberlander agreed that women who need them should not stop taking their SSRIs during pregnancy.

"These findings are consistent with what others have found," he said.

The Canadian expert believes that doctors should be sensitive to behavioural outcomes in infants exposed to SSRIs. "We don't know enough about the long-term effects of SSRIs," he said.

Mother's mood biggest predictor
In his own research, Oberlander found that a mom's emotional state seems to be the biggest predictor of her child's long-term behaviour. "It's the mother's mood that seems to have the greatest long-term effect, not prenatal exposure to SSRIs."

"The concern should not just be with [neonatal] withdrawal behaviour," he said. "We should be sensitive to special needs of these babies, not because they were drug-exposed, but because the mothers were depressed. That is the biggest risk factor these babies have." – (HealthDayNews)

Read more: Blues lingers during pregnancy

February 2006
 

Print this article on

Rate this article Poor 1 2 3 4 5 Excellent