Maternale antidepressiva tijdens de zwangerschap en de lactatie: Literatuuroverzicht van de pre- en postnatale effecten op het kind

Depression is a major health concern, affecting predominantly women during their childbearing and childrearing age. Since these women are usually excluded from pharmacological research, the use of antidepressants during pregnancy and lactation is rarely studied. The negative consequences of an untreated maternal depression, on both mother and child, have the ascendancy over the possible adverse effects of in utero exposure to antidepressants. This important message results from a literature study concerning the influence of selective serotonin re-uptake inhibitors (SSRI's) on the child during the prenatal and the postnatal period. Over-all, the outcome of the child after exposure to these drugs is positive. However, some postnatal neurologic signs (withdrawal versus toxicity) as well as non-neurologic points of discussion (primary pulmonary hypertension of the neonate and prolongation of the corrected QT-interval) after perinatal exposure to SSRI's are discussed in the manuscript. So far, the long-term effects of in utero exposure to antidepressants on the development of the child appear reassuring, but further research in this field is necessary. Current evidence on the use of 5 important SSRI's (fluoxetine, paroxetine, sertraline, citalopram and escitalopram) during lactation is also discussed. This overview aims to guide caregivers in optimal mother-and-child healthcare during maternal depression.