Affiliations: [a] Department of Pharmacy Services, Hillcrest – Cleveland Clinic, Mayfield Heights, OH, USA
| [b] Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| [c] Department of Neonatology, Cleveland Clinic Children’s Hospital, Cleveland, OH, USA
Correspondence:
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Address for correspondence: M.E. Temple-Cooper, Department of Pharmacy Services, Hillcrest – Cleveland Clinic, Mayfield Heights, OH, USA. E-mail: mtemple@ccf.org.
Abstract: OBJECTIVE:We hypothesized that in-utero SSRI exposure affects Apgar scores and immediate post-delivery oxygen requirements. STUDY DESIGN:SSRI in-utero exposure was assessed retrospectively in preterm neonates ≥ 28 weeks gestation and term neonates. Primary outcome was Apgar <7 at five minutes and delivery room oxygen requirements. Secondary endpoints included one-minute Apgar, length of stay, birth weight, and NICU admission. RESULTS:Fifty-one preterm and 117 term neonates were exposed to a SSRI; mostly to sertraline. Pre-term SSRI-exposed neonates had 4.1 times higher delivery room oxygen requirements. One minute Apgar <7 was 3.5 times higher and NICU admission 5 times higher 95% CI (1.3–19) in SSRI-exposed term neonates. Higher doses of sertraline had associated adverse outcomes. CONCLUSION:In-utero SSRI exposure was associated with increased neonatal care at birth, differences in Apgar scores compared with controls, and increased NICU admissions. Higher sertraline doses were associated with poorer outcomes.
