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BMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7502.1231 (Published 26 May 2005) Cite this as: BMJ 2005;330:1231
  1. Alison Tonks, associate editor (atonks@bmj.com)

    Taking SSRIs or SNRIs in late pregnancy can harm newborns

    Women who take selective serotonin or noradrenaline reuptake inhibitors (SSRIs or SNRIs) in late pregnancy risk giving their baby a neonatal syndrome characterised by jitteriness, increased muscle tone, feeding difficulties, and sometimes respiratory distress. But the symptoms are often mild, self limiting, and easily managed with supportive measures, say researchers. After a careful look for all reports of the syndrome, they found 13 published case reports, 9 cohort studies, 57 cases reported to the US Food and Drug Administration's adverse events database, and 74 cases reported to the World Health Organization.

    Using data from the cohort studies, they estimated that babies whose mothers took these antidepressants during the last trimester were three times more likely to develop neonatal symptoms (risk ratio 3.0, 95% CI 2.0 to 4.4), 2.6 (1.4 to 4.7) times more likely to need nursing in a special care unit, and 2.3 (1.6 to 3.2) times more likely to have breathing problems than babies who were not exposed at all, or were exposed earlier in the pregnancy. Reported symptoms were fairly consistent (figure) and lasted no more than two weeks.

    We still don't know the risks associated with individual drugs and we still don't know what causes the syndrome, or how to avoid it. The US Food and Drugs Administration recently added a warning label to all SSRIs and SNRIs describing the symptoms and suggesting that women consider tapering the dose in late pregnancy.

    Credit: JAMA

    JAMA 2005;293: 2372-83

    New definition of fasting glucose is poor predictor of cardiovascular disease

    In 2003, the American Diabetes Association reduced the lower limit of normal for fasting serum concentration of glucose. Men and women with fasting glucose between 5.6 mmol/l and 6.9 mmol/l are now deemed to have have impaired fasting glucose and a higher risk of diabetes. The new definition triples the number of men and women in the United States …

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