Long-term outcome following selective serotonin reuptake inhibitor induced neonatal abstinence syndrome

• Published in: Journal of perinatology Vol. 31; no. 9; pp. 615 - 620
• Main Authors: Klinger, G, Frankenthal, D, Merlob, P, Diamond, G, Sirota, L, Levinson-Castiel, R, Linder, N, Stahl, B, Inbar, D
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01.09.2011; Nature Publishing Group
• Subjects: 692/308/409; 692/699/476/5; 692/700/1720; 692/700/565/1436; Abnormalities; Adult; Antidepressants; Behavior; Child; Child Development - drug effects; Child, Preschool; Children; Cognitive ability; Confidence intervals; Depression, Mental; Drug therapy; Drug withdrawal; Evaluation; Female; Health aspects; Humans; Infant, Newborn; Infants (Premature); Intensive care; Male; Medicine; Medicine & Public Health; Mental Disorders - chemically induced; Mental Disorders - diagnosis; Neonatal abstinence syndrome; Neonatal Abstinence Syndrome - etiology; Neonatal Abstinence Syndrome - psychology; Neonates; Neurodevelopment; Neuropsychological Tests; Newborn babies; original-article; Pediatric Surgery; Pediatrics; Pregnancy; Prenatal Exposure Delayed Effects; Prospective Studies; Regression analysis; Risk factors; Risk taking; Serotonin; Serotonin uptake inhibitors; Serotonin Uptake Inhibitors - adverse effects; Serotonin Uptake Inhibitors - pharmacology; Social behavior; Statistical analysis; Treatment Outcome; Israel; Tel Aviv Israel; long-term outcome; selective serotonin reuptake inhibitor; neonatal abstinence syndrome
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/jp.2010.211

Objective: To assess the long-term neurodevelopment of children exposed in utero to selective serotonin reuptake inhibitors (SSRIs) that developed a neonatal abstinence syndrome (NAS). Study Design: Neurodevelopmental evaluation was performed at the age of 2 to 6 years. Children who developed NAS were compared with those who did not using univariate and logistic regression analyses. Result: Thirty children with NAS and 52 without NAS participated in the study. Both groups were similar in mean cognitive ability (106.9±14.0 vs 100.5±14.6, P =0.12) and developmental scores (98.9±11.4 vs 95.7±9.9, P =0.21). However, there was a trend towards small head circumference in the NAS group (20 vs 6%, P =0.068). NAS was associated with an increased risk of social-behavior abnormalities (odds ratio (OR) 3.03, 95% confidence interval (CI) 1.07 to 8.60, P =0.04) and advanced maternal age (OR 1.12, 95% CI 1.00 to 1.25, P =0.04). Conclusion: Infants who developed NAS had normal cognitive ability, but were at an increased risk for social-behavioral abnormalities. Follow-up evaluation of symptomatic neonates should be considered.