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Title: Use of Antidepressants in Pregnancy Affects Neonatal Outcomes: Presented at AACAP
URL: http://www.pslgroup.com/dg/2166BE.htm
Doctor's Guide
October 29, 2007


By Maria Bishop

BOSTON, MA -- October 29, 2007 -- Babies born to mothers who take antidepressant medication during pregnancy have high levels of cortisol in cord-blood at birth, and their mothers are more likely to experience delivery complications, according to a study presented here at the 54th Annual Meeting of the American Academy of Child & Adolescent Psychiatry (AACAP).

When examined at 2 weeks of age, the infants of women taking antidepressants demonstrated more tremulousness and were more excitable than infants born to women not taking antidepressants.

The study results were presented by lead author Sheila Marcus, MD, Clinical Associate Professor, Departments of Psychiatry and Depression Center, University of Michigan, Ann Arbor, Michigan, United States, on October 24.

Since 1998, approximately 135 pregnant women enrolled in the University of Michigan study examining the impact of maternal distress on infant neurological development; pregnancy outcomes; and maternal and infant regulation of the endocrine stress response system (limbic-hypothalamic-pituitary-adrenal [LHPA axis]).

A smaller subgroup of eligible women with controlled demographic factors participated in a structured clinical diagnostic interview and was divided into three groups according to psychiatric diagnoses: low-risk (n = 28), high-risk/major depressive disorder (MDD) (n = 63); and high-risk/MDD + medication (n = 11).

The Neonatal Intensive Care Network Neurobehavioural Scale (NNNS) was utilised to provide a comprehensive examination of the normal and the at-risk neonates. A higher score on each scale means a higher level of the construct. NNNS scores for tremulousness were 3.5 for the babies in the high-risk + medication subjects and 2.25 for babies born to both groups of nonmedicated subjects (P <.05).

Levels of adrenocorticotropic hormone in the cord blood were found to be 325 pg/mL in high-risk patients taking medication compared with 225 pg/mL in the nonmedicated group and 125 pg/mL in the low-risk group.

The major limitation of the study, Dr. Marcus noted, is the fact that high-risk/depressed women using medication had greater symptom severity than those not using medication, so the affect of symptom severity on these results requires further examination.
This research is supported by grants from the National Institute of Mental Health.


[Presentation title: Antidepressant Medication and Depression Status: Impact on Neonatal Outcomes. Abstract A01]

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