Short-term neonatal outcome among term infants after in utero exposure to serotonin reuptake inhibitors.

BACKGROUND: Serotonin reuptake inhibitor (SRI) medications are commonly in use during pregnancy.

OBJECTIVES: To evaluate short-term neonatal clinical signs among infants exposed to intrauterine SRI medications, in order to estimate the need for postnatal monitoring and observation.

METHODS: Retrospective review of clinical data in medical files of term infants born to mothers who reported treatment with SRIs during pregnancy.

RESULTS: Out of 401 infants in the study group, 165 (41%) were reported to have at least 1 clinical symptom, including respiratory distress, jitteriness, restlessness, feeding difficulties, regurgitations, fever ≥38°C, a short cyanotic event and convulsions. In the symptomatic group, 70% exhibited mild symptoms, among them restlessness, jitteriness or feeding difficulties, while around 30% exhibited significant symptoms. Overall, 12% of the total cohort, mostly males (70%), presented significant clinical symptoms, but none had an urgent or life-threatening condition. Infants in the study group were shorter in length and had a higher rate of Apgar score <7 at 1 min, meconium-stained amniotic fluid and respiratory distress.

CONCLUSIONS: Despite the high incidence of clinical signs among infants born to SRI-treated mothers, most of their symptoms were mild and self-limited. These infants should be observed while they are close to their mothers on the maternity ward for 48 h after birth.