妊娠期使用抗抑郁药物的安全性评价

Safety Evaluation of Selective Use of Antidepressants During Pregnancy

探讨妊娠期使用抗抑郁药物的安全性,为临床用药提供参考。结合指南、文献及数据库检索等循证证据,对抗抑郁药物在妊娠期使用的致畸性、母婴妊娠结局、子代远期影响进行综述以评价安全性。妊娠期使用抗抑郁药物可能存在致畸、自然流产、新生儿戒断综合征、子痫前期和产后出血等风险,且会对后代产生一定远期影响。5-羟色胺再摄取抑制药在妊娠期使用安全性较高,其中舍曲林和西酞普兰推荐为一线用药。有必要开展妊娠期用药研究以获得更多循证证据支持。

To explore the safety of antidepressant use during pregnancy and to provide a reference for antidepressant use during pregnancy.Based on clinical evidence such as guidelines,literature,and database search,the teratogenicity,maternal and infant pregnancy outcomes,and long-term effects of antidepressants in pregnancy were reviewed to evaluate their safety.The use of antidepressants during pregnancy may lead to teratogenesis,spontaneous abortion,neonatal withdrawal syndrome,preeclampsia and postpartum bleeding,and may have some long-term effects on offspring.Current evidence shows that serotonin reuptake inhibitors(SSRIs)are safe to be used in pregnancy,among which sertraline and citalopram are recommended as first-line drugs.It is necessary to carry out studies on the use of SSRIs in pregnancy to obtain more clinical evidence support.