The Effect of SSRI Exposure in Pregnancy on Early Respiratory and Metabolic Adaptation in Infants Born Preterm
Abstract
:1. Introduction
2. Materials and Methods
- (a)
- Maternal demographics and health status, pregnancy-related complications and use of prenatal steroids;
- (b)
- Early-onset sepsis risk factors (maternal positive GBS swab, prolonged rupture of membranes and maternal fever), gestational age, birth weight and sex of the newborn, need for advanced delivery room resuscitation (advanced airway or chest compressions), cord pH and Apgar scores;
- (c)
- Early respiratory and metabolic neonatal adaptation parameters including hypoglycemia episodes, need for hypoglycemia treatment, body temperature regulation, need for respiratory support, need for surfactant treatment, need for inotropes, highest bilirubin level, need for phototherapy, serum sodium levels and time to regaining birth weight;
- (d)
3. Results
3.1. Early Neonatal Adaptaion
3.1.1. Delivery Room Parameters
3.1.2. Early Respiratory Adaptation
3.1.3. Early Metabolic Adaptation
3.2. Short Term Outcomes and Complications of Prematurity
4. Discussion
4.1. Delivery Room Parameters
4.2. Early Respiratory Adaptation
4.3. Early Metabolic Adaptation
4.4. Other Short-Term Outcomes
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Parameter | SSRI Exposure n = 21 | No SSRI Exposure n = 21 | p-Value |
---|---|---|---|
Mode of delivery n (%) | 1.0 | ||
Vaginal | 6 (28.5) | 7 (33.3) | |
Cesarean section | 15 (71.4) | 14 (66.6) | |
Multiple pregnancy n (%) | 0.093 | ||
Singleton | 15 (71.4) | 20 (95.2) | |
Twin | 6 (28.5) | 1 (4.7) | |
Prenatal steroids n (%) | 11 (52.3) | 17 (80.9) | 0.102 |
Risk factors for early neonatal sepsis * n (%) | 5 (23.8) | 9 (42.8) | 0.326 |
Maternal hypertension or preeclampsia n (%) | 5 (23.8) | 2 (9.5) | 0.410 |
Sex n (%) | 0.755 | ||
Male | 12 (57.1) | 12 (57.1) | |
Female | 9 (42.8) | 9 (42.8) | |
Gestational age *** weeks | 34.4 (30.6, 34.9) | 34.1 (30.7, 34.9) | 0.980 |
Birth weight ** g | 1938 ± 745 | 1945 ± 636 | 0.974 |
Weight for gestational age n (%) | 0.834 | ||
SGA | 2 (9.5) | 1 (4.7) | |
AGA | 17 (80.9) | 18 (85.7) | |
LGA | 2 (9.5) | 2 (9.5) | |
Head circumference ** cm | 29.8 ± 3.4 | 29.9 ± 2.7 | 0.951 |
Parameter | SSRI Exposure n = 21 | No SSRI Exposure n = 21 | p-Value |
---|---|---|---|
1 min Apgar ** | 8 (5.7, 9.0) | 9 (8.0, 9.0) | 0.043 |
5 min Apgar ** | 9 (9.0, 10.0) | 10 (9.0, 10.0) | 0.120 |
Cord pH ** | 7.34 (7.29, 7.38) | 7.33 (7.3, 7.35) | 0.791 |
Delivery room advanced resuscitation n (%) | 3 (14.2) | 2 (9.5) | 1.0 |
Respiratory support—first 3 days of life n (%) | 16 (76.2) | 14 (66.6) | 0.541 |
Mechanical ventilation—first week of life, n (%) | 6 (28.5) | 4 (19.0) | 0.717 |
Surfactant treatment n (%) | 7 (33.3) | 9 (42.8) | 0.751 |
Maximal FiO2 requirements—first week of life * (FiO2%) | 25.7 ± 3.6 | 28 ± 2.9 | 0.102 |
Maximal bilirubin ** (mg/dL) | 11.6 (10.5, 12.5) | 11.2 (9.6, 12.7) | 0.624 |
Phototherapy * (days) | 2.0 ± 1.4 | 1.4 ± 1.2 | 0.896 |
Lowest blood glucose—first week of life * (mg/dL) | 56 ± 15 | 53 ± 13.3 | 0.568 |
Need for hypoglycemia treatment n (%) | 8 (38.0) | 12 (57.1) | 0.354 |
Lowest serum sodium in serum—first week of life * | 136 ± 5.5 | 136 ± 4.4 | 0.978 |
Serum sodium < 130 mg/dL n (%) | 4 (19.0) | 1 (4.7) | 0.345 |
Maximal body temperature—first week of life ** | 37.4 (37.4, 37.5) | 37.4 (37.2, 37.5) | 0.622 |
Parameter | SSRI Exposure n = 21 | No SSRI Exposure n = 21 | p-Value |
---|---|---|---|
Length of stay ** (days) | 21 (9.5, 49.5) | 16 (8.5, 45.0) | 0.371 |
Time off positive pressure ventilation ** (days) | 2.5 (1.0, 6.5) | 4.0 (2.0, 7.5) | 0.403 |
Time off supplemental oxygen ** (days) | 3 (2.0, 35.2) | 7.5 (2.0, 22.0) | 0.623 |
Time to full enteral feeds ** (days) | 5 (2.0, 8.2) | 5 (2.0, 7.2) | 0.840 |
Time to regaining birth weight ** (days) | 8 (6.7, 9.0) | 9 (5.7, 14.0) | 0.340 |
Antibiotic treatment-first week of life * (days) | 2.8 ± 4.4 | 1.4 ± 1.8 | 0.229 |
Number of sepsis workups ** | 1 (1.0, 2.25) | 1 (1.0, 2.0) | 0.654 |
BPD n (%) | 5 (23.8) | 3 (14.2) | 0.695 |
IVH n (%) | 1 (4.7) | 5 ( 23.8 ) | 0.077 |
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Gover, A.; Endrawes, K.; Molad, M.; Lavie-Nevo, K.; Riskin, A. The Effect of SSRI Exposure in Pregnancy on Early Respiratory and Metabolic Adaptation in Infants Born Preterm. Children 2023, 10, 508. https://doi.org/10.3390/children10030508
Gover A, Endrawes K, Molad M, Lavie-Nevo K, Riskin A. The Effect of SSRI Exposure in Pregnancy on Early Respiratory and Metabolic Adaptation in Infants Born Preterm. Children. 2023; 10(3):508. https://doi.org/10.3390/children10030508
Chicago/Turabian StyleGover, Ayala, Kareen Endrawes, Michal Molad, Karen Lavie-Nevo, and Arieh Riskin. 2023. "The Effect of SSRI Exposure in Pregnancy on Early Respiratory and Metabolic Adaptation in Infants Born Preterm" Children 10, no. 3: 508. https://doi.org/10.3390/children10030508