Geburtshilfe und Frauenheilkunde · 2026
Consequences of Maternal Antidepressant and Anticonvulsant Use During Pregnancy: Is Postnatal Inpatient Monitoring Required? - A Retrospective Cohort Study.
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Hell Antonia, Hébert Steven, Mulzer Linda, Hanslik Gregor, Woefle Joachim, Schneider Michael O, Beckmann Matthias W, Reutter Heiko, Morhart Patrick
Аннотация
INTRODUCTION: Prenatal exposure to antidepressants and anticonvulsants is steadily increasing in parallel with rising prescription rates. Our study focused on potential postnatal adjustment disorders in newborns and their appropriate monitoring after birth.
OBJECTIVE: To descriptively assess clinically relevant complications in neonates after intrauterine exposure to antidepressants and/or anticonvulsants and to evaluate the need for routine postnatal monitoring.
METHODS: We conducted a retrospective single-center cohort study at the University Hospital Erlangen (01/2021-12/2023). The study included 120 neonates whose mothers received antidepressants, anticonvulsants, or both during pregnancy. The primary endpoint was a clinically relevant respiratory event (apnea, dyspnea/desaturation, or need for ventilatory support). An exploratory multivariable logistic regression with the primary endpoint as the outcome was performed (main analysis: gestational age, maternal age, cesarean delivery; sensitivity analysis additionally including exposure group).
RESULTS: The primary endpoint occurred in 31/120 neonates (25.8%). In the main multivariable analysis, gestational age, maternal age, and cesarean delivery showed no statistically significant association with the primary endpoint; in a sensitivity analysis additionally including exposure group, no significant between-group differences were observed. Numeric time-to-event data were available for 22 respiratory events (median 32.5 h; mean 42.0 h); 16/22 (72.7%) occurred within 48 h and 6/22 (27.3%) after 48 h. Hypoglycemia was documented in 15/120 neonates (12.5%) without significant differences between exposure groups.
CONCLUSION: Clinically relevant respiratory events were observed in this monitored cohort of exposed neonates. An initial monitoring period of at least 48 h appears to represent a pragmatic minimum standard. In the presence of clinical abnormalities, risk-adapted prolonged monitoring may be appropriate.
OBJECTIVE: To descriptively assess clinically relevant complications in neonates after intrauterine exposure to antidepressants and/or anticonvulsants and to evaluate the need for routine postnatal monitoring.
METHODS: We conducted a retrospective single-center cohort study at the University Hospital Erlangen (01/2021-12/2023). The study included 120 neonates whose mothers received antidepressants, anticonvulsants, or both during pregnancy. The primary endpoint was a clinically relevant respiratory event (apnea, dyspnea/desaturation, or need for ventilatory support). An exploratory multivariable logistic regression with the primary endpoint as the outcome was performed (main analysis: gestational age, maternal age, cesarean delivery; sensitivity analysis additionally including exposure group).
RESULTS: The primary endpoint occurred in 31/120 neonates (25.8%). In the main multivariable analysis, gestational age, maternal age, and cesarean delivery showed no statistically significant association with the primary endpoint; in a sensitivity analysis additionally including exposure group, no significant between-group differences were observed. Numeric time-to-event data were available for 22 respiratory events (median 32.5 h; mean 42.0 h); 16/22 (72.7%) occurred within 48 h and 6/22 (27.3%) after 48 h. Hypoglycemia was documented in 15/120 neonates (12.5%) without significant differences between exposure groups.
CONCLUSION: Clinically relevant respiratory events were observed in this monitored cohort of exposed neonates. An initial monitoring period of at least 48 h appears to represent a pragmatic minimum standard. In the presence of clinical abnormalities, risk-adapted prolonged monitoring may be appropriate.