Introduction: A clear picture of neonatal withdrawal signs due to in utero selective serotonin reuptake inhibitor (SSRI) exposure and its consequences is still missing. Objective: A systematic review and a meta-analysis were performed to provide an overview of neonatal withdrawal signs following late in utero exposure to SSRIs and to quantify the corresponding risks. Methods: MEDLINE, Web of Science, and Embase were searched from inception to January 2021. The Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines were followed. English-language observational studies reporting on acute postpartum outcomes following late in utero exposure to SSRIs or SSRIs/venlafaxine were evaluated. Results: Of 2,269 citations reviewed, 79 studies were assessed for eligibility; 13 were included in the qualitative analysis of the literature, which allowed us to identify 26 signs. A meta-analysis was run separately for studies on SSRI exposure (n = 3) and those on SSRI/venlafaxine exposure (n = 6). Hypoglycemia was identified as a withdrawal sign based on the SSRI studies. Tremors, hypotonia, tachycardia, rapid breathing, respiratory distress, and hypertonia were identified as withdrawal signs based on the SSRI/venlafaxine studies. Conclusions: The present work provides a framework for the identification of neonatal SSRI withdrawal syndrome. Tapering and discontinuation of antidepressant drugs before and during the early phase of pregnancy are worth attempting to prevent the occurrence of this syndrome.
Psychother Psychosom

中文翻译：

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子宫内晚期暴露于选择性血清素再摄取抑制剂后的新生儿戒断综合征：观察性研究的系统评价和荟萃分析

介绍：由于子宫内选择性血清素再摄取抑制剂 (SSRI) 暴露及其后果的新生儿戒断症状的清晰图片仍然缺失。目的：进行了系统评价和荟萃分析，以概述子宫内晚期暴露于 SSRI 后的新生儿戒断症状，​​并量化相应的风险。方法：从开始到 2021 年 1 月检索 MEDLINE、Web of Science 和 Embase。遵循流行病学观察性研究的元分析 (MOOSE) 指南。对报告宫内晚期暴露于 SSRIs 或 SSRIs/文拉法辛后急性产后结果的英语观察性研究进行了评估。结果：在审查的 2,269 篇引文中，79 项研究被评估为合格；13 个被纳入文献的定性分析，这使我们能够识别 26 个迹象。对 SSRI 暴露研究 ( n = 3) 和 SSRI/文拉法辛暴露研究 ( n = 6)分别进行了荟萃分析。根据 SSRI 研究，低血糖被确定为戒断迹象。根据 SSRI/文拉法辛研究，震颤、肌张力减退、心动过速、呼吸急促、呼吸窘迫和肌张力亢进被确定为戒断症状。结论：目前的工作为识别新生儿 SSRI 戒断综合征提供了一个框架。在怀孕前和怀孕早期逐渐减少和停用抗抑郁药物是值得尝试预防这种综合征的发生。
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