BJPsych：孕期使用SSRIs可致新生儿阿氏评分降低

　　怀孕期间使用抗抑郁药或致新生儿阿氏评分（Apgar scores）降低。但是，潜在的抑郁障碍或许会影响这种联系。近期《英国精神病学杂志》在线版刊登的一篇研究对孕妇抑郁症，及出生后5分钟阿氏评分内小于7的新生儿其母孕期抗抑郁药使用情况进行分析后得出结论，孕期使用选择性5-羟色胺再摄取抑制剂（SSRIs），可独立的增加新生儿阿氏评分降低的风险。

　　研究对1996-2006年间丹麦全国范围内怀孕妇女的个体化资料进行注册研究，相关资料来自医学出生记录、精神病学中心记录及国家处方数据库。

　　胎儿期暴露于抗抑郁药的新生儿阿氏评分降低的概率增大（OR=1.72, 95%CI 1.34-2.20)，但这种概率的增大仅限于胎儿期暴露于SSRIs的新生儿(OR = 1.96, 95% CI 1.52-2.54)，不包括暴露于更新型(OR = 0.83, 95% CI 0.40-1.74)或更传统(OR = 0.53, 95% CI 0.19-1.45)的抗抑郁药的新生儿。未使用抗抑郁药的孕前及孕期抑郁症与阿氏评分降低无关(OR = 0.44, 95% CI 0.11-1.74)。只在怀孕前使用过抗抑郁药的妇女再次妊娠，不会导致其新生儿阿氏评分降低的概率增加，这与患者的抑郁程度无关。

与抑郁相关的拓展阅读：

• BMC Med:抗抑郁药与艰难梭菌感染相关
• PNAS：抑郁症破坏基因表达的日常模式
• BJPsych：老年抑郁增加痴呆事件发生风险
• Psychother Psychosom：美国成人抑郁症常被过度诊断和治疗
• APA：米氮平在抑郁症治疗中的作用
• J. Adolesc. Health：青春期抑郁10年内易发生不良结局
更多信息请点击：有关抑郁更多资讯

Maternal depression, antidepressant use in pregnancy and Apgar scores in infants
Background
Use of antidepressants during pregnancy has been associated with a low Apgar score in infants but a contribution from the underlying depressive disorder might influence this association.
Aims
To estimate the effects of maternal depression and use of antidepressants during pregnancy on low Apgar scores (<7) 5 min after birth.
Method
Register study on all pregnant women in Denmark from 1996 to 2006 linking nationwide individualised data from the Medical Birth Register, the Psychiatric Central Register and the National Prescription database.
Results
Infants exposed to antidepressants during pregnancy had an increased rate of a low Apgar score (odds ratio (OR) = 1.72, 95% CI 1.34-2.20). The increased rate was only found among infants exposed to selective serotonin reuptake inhibitors (SSRIs) (OR = 1.96, 95% CI 1.52-2.54), not among those exposed to newer (OR = 0.83, 95% CI 0.40-1.74) or older antidepressants (OR = 0.53, 95% CI 0.19-1.45). Maternal depression before or during pregnancy, without prescription of antidepressants, was not associated with a low Apgar score (OR = 0.44, 95% CI 0.11-1.74). Women who had only used antidepressants prior to pregnancy had no increased rate of a low Apgar score in their subsequent pregnancy, regardless of depression status.
Conclusions
Use of SSRIs during pregnancy increases the risk of a low Apgar score independently of maternal depression.