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The Effect of Maternal Antidepressants on Third Trimester Uteroplacental Hemodynamics and the Neonatal Abstinence Syndrome
Friday, April 28th, 10:20 AM - 10:30 AM - Display B - Lower Lobby

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INTRODUCTION

•Mood disorders occur in 15-20% of pregnancies in North America
•One third of women with mood disorders are treated with antidepressant medication during pregnancy
•Studies have suggested antidepressant medications may be associated with impaired fetal growth and preterm birth, although the mechanisms remain unclear1,3
•Prior reports suggest neonatal withdrawal symptoms occur in up to 30% of exposed infants2
 
OBJECTIVES
 
•To determine if maternal selective serotonin reuptake inhibitor (SSRI) use during pregnancy influences uteroplacental hemodynamics as measured by 3rd trimester umbilical artery Doppler flow
•The secondary aim is to to determine the incidence of neonatal abstinence syndrome (NAS) among infants exposed to SSRIs in pregnancy at Mount Sinai Hospital (MSH)
 
METHODS
 
•A retrospective chart review was performed of women who received obstetrical care through the Special Pregnancy Program at Mount Sinai Hospital in Toronto, Ontario, Canada from January 2014 - January 2016
•Inclusion criteria: diagnosis of depression, delivery at MSH
•Exclusion criteria: substance abuse, narcotic or antipsychotic use at the time of delivery 
 
CONCLUSIONS
 
•There is no difference in 3rd trimester uteroplacental blood flow hemodynamics between those taking SSRIs in pregnancy and those who have not
•Babies born to women taking antidepressant medication during pregnancy had lower 1-minute APGAR scores but these differences were transient
•None of the exposed infants met criteria for severe withdrawal (NAS score ≥ 8 on 2 or more occasions)
•Mild neonatal abstinence (NAS score ≥ 4 on 2 or more occasions) was found in 18% of infants exposed to SSRIs
•NAS scores in infants exposed to SSRIs were lower than previously reported
•Mild tremors and sleeping less than 3 hours were the most common symptoms noted in infants
•These results lend further support for women who require antidepressant medications during pregnancy 
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