scholarly journals Severe Brief Resolved Unexplained Event in a Newborn Infant in Association with Maternal Sertralin Treatment during Pregnancy

Medicines ◽  
2018 ◽  
Vol 5 (4) ◽  
pp. 113
Author(s):  
Mirjam Pocivalnik ◽  
Manfred Danda ◽  
Berndt Urlesberger ◽  
Wolfgang Raith

Background: Selective serotonin reuptake inhibitors are a very common choice of antidepressive drug-therapy during pregnancy. In up to 30% of cases, they have been found to cause neonatal abstinence syndrome in newborn infants. Although often both time-limiting and self-limiting, severe symptoms of neonatal abstinence syndrome (NAS) can occur. Methods/Results: We report a term male infant suffering from a severe brief resolved unexplained event caused by his mother’s sertraline intake during pregnancy. Conclusions: Newborn infants exposed to selective serotonine reuptake inhibitors (SSRIs) during pregnancy should be evaluated very carefully concerning NAS and monitored for NAS symptoms for a minimum of 72–96 h, or until symptoms have fully recovered using standardized protocols. There is a risk of severe NAS symptoms which might occur, and this circumstance should be discussed with the parents and taken into account before administering the drug.

2017 ◽  
Vol 11 (4) ◽  
pp. 601-609 ◽  
Author(s):  
Paul Schadler ◽  
Jennifer Shue ◽  
Mohamed Moawad ◽  
Federico P. Girardi ◽  
Frank P. Cammisa ◽  
...  

<sec><title>Study Design</title><p>Retrospective case-control study.</p></sec><sec><title>Purpose</title><p>The purpose of this study was to examine the effect of antidepressants on blood loss and transfusion requirements in spinal surgery patients.</p></sec><sec><title>Overview of Literature</title><p>Several studies have shown an increase in perioperative bleeding in orthopedic surgery patients on antidepressant drug therapy, yet no study has examined the impact of these agents on spinal surgery patients.</p></sec><sec><title>Methods</title><p>Charts of patients who underwent single-level spinal fusion (posterior lumbar interbody fusion with posterior instrumentation) performed by five fellowship-trained surgeons at a tertiary spine center between 2008 and 2013, were retrospectively reviewed. Exclusion criteria included select medical comorbidities, select drug therapy, and Amercian Society of Anesthesiologists Physical Status Classification score of greater than 2. Serotonergic antidepressants were examined in multivariate analysis to assess their predictive value on estimated blood loss and risk of transfusion.</p></sec><sec><title>Results</title><p>A total of 235 patients, of which 52% were female, were included. Allogeneic blood was transfused in 7% of patients. The average estimated blood loss was 682±463 mL. Selective serotonin reuptake inhibitors were taken by 10% of all patients. Multivariable regression analysis showed that intake of selective serotonin reuptake inhibitors was a significant predictor for blood loss (average increase of 34%, <italic>p</italic>=0.015) and for the need of allogeneic blood transfusion (odds ratio, 4.550; <italic>p</italic>=0.029).</p></sec><sec><title>Conclusions</title><p>There was a statistically significant association between selective serotonin reuptake inhibitors and both increased blood loss and risk of allogeneic red blood cell transfusion. Surgeons and perioperative providers should take these findings into account when assessing patients' preoperative risk for blood loss and transfusion.</p></sec>


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