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Serotonin and poor neonatal adaptation after antidepressant exposure in utero

Published online by Cambridge University Press:  08 July 2016

Noera Kieviet ,
Vera van Keulen ,
Peter Marinus van de Ven ,
Koert Melchior Dolman ,
Martine Deckers  and
Adriaan Honig
Noera Kieviet*
Affiliation:
Department of Pediatrics, Psychiatry Obstetric Pediatric Expert Center, OLVG West Hospital, Amsterdam, The Netherlands
Vera van Keulen
Affiliation:
Department of Pediatrics, Psychiatry Obstetric Pediatric Expert Center, OLVG West Hospital, Amsterdam, The Netherlands
Peter Marinus van de Ven
Affiliation:
Department of Epidemiology and Biostatistics, VU Medical Center, Amsterdam, The Netherlands
Koert Melchior Dolman
Affiliation:
Department of Pediatrics, Psychiatry Obstetric Pediatric Expert Center, OLVG West Hospital, Amsterdam, The Netherlands
Martine Deckers
Affiliation:
Clinical Laboratory, OLVG West Hospital, Amsterdam, The Netherlands
Adriaan Honig
Affiliation:
Department of Psychiatry, OLVG West Hospital, AmsterdamThe Netherlands Department of Psychiatry, VU Medical Center, Amsterdam, The Netherlands
*
Dr. Noera Kieviet, OLVG West, Department of Pediatrics, Jan Tooropstraat 164, 1061 AE Amsterdam, The Netherlands. Tel: +31 20 510 8790; Fax :+31 20 685 3059; E-mail: noera.kieviet@gmail.com
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Abstract

Objective

Infants exposed to selective antidepressants (SADs) in utero are at risk to develop poor neonatal adaptation (PNA) postpartum. As symptoms are non-specific and the aetiology of PNA is unknown, the diagnostic process is hampered. We hypothesised that the serotonin metabolism plays a role in the aetiology of PNA.

Methods

In this controlled study, infants admitted postpartum from February 2012 to August 2013 were included and followed for 3 days. Infants exposed to SADs during at least the last 2 weeks of fetal life were included in the patient group (n=63). Infants not exposed to psychotropic medication and admitted postpartum for another reason were included in the control group (n=126). The neonatal urinary 5-hydroxyindoleacetid acid (5-HIAA) levels of SAD-exposed infants who developed PNA, SAD-exposed infants who did not develop PNA and control infants were compared.

Results

The course of the 5-HIAA levels over the first 3 days postpartum differed between infants with and without PNA (p≤0.001) with higher 5-HIAA levels in infants with PNA on day 1 (2.42 mmol/mol, p=0.001). Presence of maternal psychological distress modified this relationship.

Conclusions

A transient disturbance of the neonatal serotonergic system may play a role in the aetiology of PNA. Other factors, including the presence of maternal psychological distress, also seem to play a role.

Keywords

central nervous systemdepressionpsychopharmacologySSRI
Type
Original Articles
Information
Acta Neuropsychiatrica , Volume 29 , Issue 1 , February 2017 , pp. 43 - 53
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Copyright
© Scandinavian College of Neuropsychopharmacology 2016 

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