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Database - Alliance francophone pour l'accouchement respecté (AFAR)

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https://afar.info/id=1263

Created on : 24 May 2005
Modified on : 02 Dec 2007

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Bibliographical entry (without author) :

Perinatal Outcome Following Third Trimester Exposure to Paroxetine. Arch Pediatr Adolesc Med. 2002;156:1129-1132.

Author(s) :

Costei AM, Kozer E, Ho T, Ito S, Koren G.

Year of publication :

2002

URL(s) :

http://archpedi.ama-assn.org/cgi/content/abstract/…

Résumé (français)  :

Abstract (English)  :

BACKGROUND: Paroxetine hydrochloride is commonly used for maternal depression, panic disorder, and obsessive-compulsive disorder. The drug readily crosses the human placenta. Although it does not appear to increase teratogenic risk, there have been case reports of neonatal withdrawal. Symptoms were described soon after birth and lasted up to 1 month.

OBJECTIVE: To investigate whether there is a clinically important discontinuation syndrome in neonates exposed to paroxetine in utero.

METHODS: Prospective, controlled cohort study.

PATIENTS: Fifty-five pregnant women counseled prospectively by the Motherisk program in Toronto, Ontario, regarding third-trimester exposure to paroxetine and their infants were included in the study group. Pregnant women who discontinued paroxetine before the third trimester or those receiving other drugs known to cause withdrawal-type symptoms, such as opioids or benzodiazepines, were excluded. A comparison group of 27 women using paroxetine during the first or second trimester and 27 women using nonteratogenic drugs were matched for maternal age, gravity, parity, social drug use, and nonteratogenic drug use.

RESULTS: Of the 55 neonates exposed to paroxetine in late gestation, 12 had complications necessitating intensive treatment and prolonged hospitalization. The most prevalent clinical picture was respiratory distress (n = 9), followed by hypoglycemia (n = 2), and jaundice (n = 1). The symptoms disappeared within 1 to 2 weeks. In the comparison group, only 3 infants experienced complications (P = .03). In logistic regression, only third-trimester exposure to paroxetine was associated with neonatal distress (odds ratio, 9.53; 95% confidence interval, 1.14-79.3).

CONCLUSION: When used near term, paroxetine is associated with a high rate of neonatal complications, possibly caused by its common discontinuation

Sumário (português)  :

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Comments :

Texte en accès libre. En termes clairs, lorsque les antidépresseurs sont continués jusqu’à l’accouchement environ 20% des nouveaux-nés font une crise de manque sévère. Mais ce n’est pas parce qu’on les arrête avant que le foetus ne fait pas aussi une crise de manque dans le ventre de sa mère …

Argument (français) :

Plus de complications néonatales lorsque la paroxétine (Paxil) est continuée pendant le 3ième trimestre de grossesse.

Argument (English):

Argumento (português):

Keywords :

➡ depression, anxiety ; pathologies of newborn ; psychology ; maternal age

Author of this record :

Cécile Loup — 24 May 2005

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