Abstract：
Recent research suggests that fetal exposure to antidepressants (ADs) is significantly associated with fetal death, including stillbirth. However, there has been limited investigation into the timing of AD exposure during pregnancy, the specific effect of each drug, and the possibility of indication bias. To address these gaps in knowledge, we conducted a systematic review of literature and disproportionality analyses using the WHO Safety Database (VigiBaseⓇ). The systematic review provided evidence for increased risks of fetal death with exposure to any selective serotonin reuptake inhibitor (SSRI) at any time of pregnancy, stillbirth with exposure to any AD during the first trimester, and stillbirth with exposure to any SSRI during the first trimester. Disproportionality analyses revealed significant associations with citalopram, clomipramine, paroxetine, sertraline, and venlafaxine. Combining both sets of results, we conclude that exposure to ADs, especially during the first trimester of pregnancy, seems to be associated with fetal mortality, and that ADs with highest placental transfer may be particularly involved. Further research should investigate the links between ADs during early pregnancy and fetal mortality.
摘要：
最近的研究表明，胎儿暴露于抗抑郁药（ADs）与胎儿死亡显着相关，包括死产.然而,对怀孕期间AD暴露时间的调查有限，每种药物的具体效果，以及指征偏差的可能性。为了解决这些知识上的差距，我们使用世卫组织安全数据库(VigiBases®)对文献和不相称性分析进行了系统回顾.系统评价提供了在妊娠任何时间接触任何选择性5-羟色胺再摄取抑制剂（SSRI）的胎儿死亡风险增加的证据。在妊娠早期暴露于任何AD的死产，和在妊娠早期暴露于任何SSRI的死产。不成比例分析显示与西酞普兰有显著关联，氯米帕明,帕罗西汀,舍曲林,和文拉法辛.结合两组结果，我们得出结论，暴露于广告，尤其是在怀孕的头三个月，似乎与胎儿死亡率有关,胎盘转移最高的AD可能特别涉及。进一步的研究应该调查妊娠早期AD与胎儿死亡率之间的联系。
