Am J Psychiatry：胎儿期SSRIs暴露对婴儿生长无明显影响

　　近期刊发于《美国精神病学杂志》（The American Journal of Psychiatry）网络版的一项前瞻性观察研究的结果显示，母亲孕期患有重度抑郁症或胎儿期选择性5-羟色胺再摄取抑制剂（SSRIs）暴露对婴儿出生后12个月内的体重、身长及头围增长无影响。

　　研究比较了出生第一年内，孕期重度抑郁症妇女所产婴儿，与孕期未接受抗抑郁治疗的、孕期服用过SSRIs的抑郁症妇女或无抑郁症未用药的妇女所产的婴儿，在体重、身长及头围增长情况的差异。研究人员根据以下原则将对照样本不重叠的分为3组：1、无SSRIs无抑郁症组（N=97）2、SSRIs组（N=46）及3、重症抑郁无SSRIs组（N=31）。

　　研究分别在孕期第20、30及36周对各组受试孕妇进行评估，并在产后第2、12、26及52周对受试母亲及其婴儿进行评估。对比各组受试母亲的人口统计学数据、临床特点及新生儿的转归。在产后的任一评估时间点，测量婴儿体重、身长及头围的医生及医生助理均不了解母亲抑郁症及胎儿期SSRIs暴露等级。

　　研究发现，无论分析结果是否经校正，出生后12月内，婴儿的体重、身长及头围的增长与母亲孕期重度抑郁症、胎儿期SSRIs暴露无显著联系。此外，研究人员对组内相互影响及孕前体重指数（prepregnancy body mass index）也进行了评估，结果未发现存在显著的协同作用。随时间推移，各组婴儿体重、身长及头围未出现的差异化变异。

Does Fetal Exposure to SSRIs or Maternal Depression Impact Infant Growth?
Objective 
The aim of this study was to compare the growth of infants born to women with antenatal major depressive disorder, either untreated or treated with selective serotonin reuptake inhibitor (SSRI) antidepressants, and infants born to a nondepressed, nonmedicated comparison group across the first year of life.
Method 
In this prospective observational study, pregnant women were evaluated at weeks 20, 30, and 36 of gestation, and mother and infant pairs were assessed at 2, 12, 26, and 52 weeks postpartum. Three nonoverlapping groups of women were defined according to their pregnancy exposures: 1) no SSRI and no depression (N=97), 2) SSRI (N=46), and 3) major depression without SSRI (N=31). Maternal demographic and clinical characteristics and newborn outcomes were compared across exposure groups. Infant weight, length, and head circumference were measured by a physician or physician’s assistant who was blind to depression and SSRI exposure status at each postpartum time point.
Results 
Both adjusted and unadjusted analyses revealed neither antenatal major depression nor SSRI exposure was significantly associated with infant weight, length, or head circumference relative to nonexposure to either. In addition, the interaction of group and prepregnancy body mass index was also evaluated, and no significant synergistic effect was identified. Similarly, no differential effect of group over time was observed for weight, length, or head circumference.
Conclusions 
In utero exposure to major depression or SSRI antidepressants did not affect infant growth with respect to weight, length, or head circumference from birth through 12 months of age.