Effects of paroxetine on the safety of mothers and infants in the second and third trimesters of pregnancy： a meta-analysis

LU Liqing; WAN Ning; JI Bo; YUAN Jin; WEN Huiying; XIAO Weibin

doi:10.6039/j.issn.1001-0408.2023.03.20

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Effects of paroxetine on the safety of mothers and infants in the second and third trimesters of pregnancy： a meta-analysis

更新时间：2023-02-22

- Effects of paroxetine on the safety of mothers and infants in the second and third trimesters of pregnancy： a meta-analysis
- ZHONGGUO YAOFANG Vol. 34, Issue 3, Pages: 361-365(2023)
- 作者机构：
  
  中国人民解放军南部战区总医院临床药学科，广州　510010
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2023.03.20
  CLC： R969.3;R971+.43
- Published：15 February 2023，
  
  Received：28 July 2022，
  
  Revised：26 December 2022，
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卢丽清,万宁,季波等.妊娠中晚期使用帕罗西汀对母婴安全性影响的Meta分析 ^Δ[J].中国药房,2023,34(03):361-365.

LU Liqing,WAN Ning,JI Bo,et al.Effects of paroxetine on the safety of mothers and infants in the second and third trimesters of pregnancy： a meta-analysis[J].ZHONGGUO YAOFANG,2023,34(03):361-365.
卢丽清,万宁,季波等.妊娠中晚期使用帕罗西汀对母婴安全性影响的Meta分析 ^Δ[J].中国药房,2023,34(03):361-365. DOI： 10.6039/j.issn.1001-0408.2023.03.20.

LU Liqing,WAN Ning,JI Bo,et al.Effects of paroxetine on the safety of mothers and infants in the second and third trimesters of pregnancy： a meta-analysis[J].ZHONGGUO YAOFANG,2023,34(03):361-365. DOI： 10.6039/j.issn.1001-0408.2023.03.20.

摘要

目的

系统评价妊娠合并抑郁症患者妊娠中晚期使用帕罗西汀对母婴的安全性，为临床合理使用该药提供参考。

方法

计算机检索 Cochrane Library、PubMed、Embase、维普网、中国知网、万方数据库和 SinoMed数据库，并进行手工检索，收集关于妊娠中晚期使用帕罗西汀对比使用其他类5-羟色胺选择性重摄取抑制剂（SSRI）的抑郁症患者的随机对照研究或者观察性研究，检索时限均为建库起至2022年8月。利用Cochrane系统评价员手册5.1.0或纽卡斯尔-渥太华质量评估表（NOS）进行文献质量评价，采用RevMan 5.4.1软件进行Meta分析。

结果

最终共纳入9项观察性研究，NOS评分均为高等质量。对其中8项队列研究进行Meta分析。结果显示，妊娠中晚期使用帕罗西汀的母婴不良妊娠结局总发生率[RR＝0.99，95%CI（0.89，1.10），

＝0.87]以及产妇不良妊娠结局总发生率[RR＝0.98，95%CI （0.87，1.10），

＝0.69]、早产发生率[RR＝0.89，95%CI （0.43，1.83），

＝0.75]均低于妊娠中晚期使用其他SSRI，但差异均无统计学意义；妊娠中晚期使用帕罗西汀的新生儿并发症总发生率高于妊娠中晚期使用其他SSRI，但差异也无统计学意义[RR＝1.02，95%CI （0.82，1.29），

＝0.84]。有1项研究报道帕罗西汀组新生儿肺动脉高压发生率高于其他SSRI组（0.4% vs. 0.3%）。

结论

妊娠中晚期使用帕罗西汀与使用SSRI相比安全性相当，但需警惕新生儿肺动脉高压的发生。

Abstract

OBJECTIVE

To systematically evaluate the safety of paroxetine in the treatment of pregnant patients with depression in the second and third trimesters of pregnancy， and provide reference for rational clinical use of it.

METHODS

Retrieved from Cochrane Library， PubMed， Embase， VIP， CNKI， Wanfang database and SinoMed database， by manual search， randomized controlled studies or observational studies were collected on depression patients who were given paroxetine vs. selective serotonin reuptake inhibitor （SSRI） in the second and third trimesters of pregnancy during the inception to Aug. 2022. Methodological qualities of the included studies were assessed by Cochrane Handbook 5.1.0 or Newcastle-Ottawa Scale （NOS）. Meta-analysis was performed with RevMan 5.4.1 software.

RESULTS

Finally， 9 observational studies were included， and all included studies were of high quality in NOS scale. Meta-analysis was performed on 8 cohort studies. Meta-analysis showed that the total incidence of adverse pregnancy outcomes of mothers and infants [RR＝0.99， 95%CI（0.89，1.10），

＝0.87]， total incidence of maternal adverse pregnancy outcomes [RR＝0.98， 95%CI （0.87，1.10），

＝0.69] and premature birth [RR＝0.89， 95%CI （0.43，1.83），

＝0.75] in the second and third trimesters of pregnancy were lower than that with other SSRI， without statistical significance. The incidence of neonatal complications with paroxetine in the second and third trimesters of pregnancy was higher than that with other SSRI， but the difference was not statistically significant [RR＝1.02， 95%CI （0.82，1.29），

＝0.84]. One study reported that the incidence of neonatal pulmonary hypertension in paroxetine g

roup was higher than that in other SSRI group （0.4% vs. 0.3%）.

CONCLUSIONS

The safety of peroxetine in the second and third trimesters of pregnancy is comparable with that of other SSRI， but it is necessary to be alert to the occurrence of neonatal pulmonary hypertension.

关键词

帕罗西汀妊娠中晚期妊娠并发症不良妊娠结局Meta分析

Keywords

second and third trimesters of pregnancypregnancy complicationsadverse pregnancy outcomemeta-analysis

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