[Intrauterine exposure to SSRIs: no reason for routine hypoglycaemia screening]

Abstract

Objective: To investigate whether neonates who have been exposed to selective serotonin reuptake inhibitors (SSRIs) in utero have a higher risk of hypoglycaemia than unexposed neonates.

Design: Systematic review of cohort studies.

Methods: We searched in PubMed and Embase for available cohort studies in which neonates exposed to SSRIs in utero were compared to non-exposed neonates, with hypoglycaemia as an outcome parameter. The studies were evaluated with respect to methodological quality by applying the 'Guidelines for assessing quality in prognostic studies' (QUIPS). The results were noted qualitatively.

Results: We found 4 studies that were suitable for further analysis. The studies were similar in design but led to very variable results. Important confounders differed greatly between studies and were not corrected for. Therefore, with these studies no answer could be given to the research question.

Conclusion: The literature does not contain enough evidence to conclude that neonates exposed to SSRIs during pregnancy have a higher risk of developing hypoglycaemia than non-exposed neonates. Only when a neonate shows clinical signs that can be attributed to both hypoglycaemia and withdrawal symptoms a single glucose check is indicated.