2023年妊娠期抑郁症的药物治疗专家共识（完整版）

2023年妊娠期抑郁症的药物治疗专家共识(完整版)A:患者在2周内经历5种或更多症状表现出较既往有显著的功能变化，2.2致畸性循环发生障碍，而引起的心房和(或)动脉导管水平血液的右向左分流，重大畸形。Lassen等人对3186名妊娠期暴露于文拉法辛的婴儿和107的统计学上的关联[34]。最近的一项meta分析[35]和几项队列研究Toh等人报道，5532名未接受SSRIs治疗的抑郁症孕妇中有9.0%诊断为妊娠期高血压，199名接受SSRIs治疗的女性中有19.1%诊断妊娠期高血压的风险(4.5%)与未接受治疗(4.5%)相比无差别[47]。早产产的风险不增加(1.85,95%CI:0.79-4.29)[61]。露于SSRIs的婴儿发生PPHN的绝对风险为1%-2%[66],而一般新生儿对风险在0.2%至0.3%之间[68-71]。但是母亲抑郁、肥胖、吸烟和手术苯二氮卓类药物(BDZs):在宫内接触BDZs的新生儿中，有20%至40%推荐2推荐1推荐3推荐4推荐5信息材料(如科普文章或科学论文),在知情情况下作出共同决定。抗抑Med.2004,158,312-316.[Crnewborn?Neuropsychiatr.Dis.Treat.2013,9,1257-1266.[Cr3.Laine,K;Heikkinen,T;Ekblad,U.;Kero,PEffectsofexposuretoselectiveGen.Psychiatry2003,60,720-726.[CrossRef][PubM4.Alwan,S;Reefhuis,J;Rasmussen,S.A;Olney,R.S.;Frselectiveserotonin-reuptakeinhibitorsinpregnancyand5.Davis,R.L.;Rubanowice,D.;McPhillips,H.;Raebel,M.A.;Andrade,S.E.;Smith,D;Yood,M.eventsamonginfantsexpos6.Malm,H.;Artama,M;Gissler,M.;Ritvanen,A.Selectiveserotoninreuptakeinhianomalies.Obstet.Gynecol.2011,118,111-120.7.Louik,C;Lin,A.E;Werler,M.M.;Hernandez-Diaz,S;Mitchell,A.A.First-trimesteruseofselreuptakeinhibitorsandtheriskofbirthdefects.N.Engl.J.Med.2007,38.Oberlander,T.F;Warburton,W;Misri,S.;Riggs,W;Aghajanian,J;Hertzman,C.Majorcongenitalmalformationsdata.BirthDefectsRes.B.Dev.Reprod.Toxico9.Wichman,C.L;Moore,K.M.;Lang,T.R;StSauver,J.L;Heise,R.H.,Jr;Watson,WJ.Conassociatedwithselectiveserotonin10.Lassen,D;Ennis,Z.N;Damkier,R.Firstmajorcongenitalmalformations:Asystematicreview11.Hendson,L.;Shah,V;Trkulja,S.Selectivesinhibitorsinpregnancy:Infantandchildhoodoutcomes.Paediatr.Child.Health20213.Polen,K.N.;Rasmussen,S.A;Riehle-Colarusso,T.study,1997-2007.BirthDefectsRes.AClin.Mol.Teratol.2013,97,28-314.Huybrechts,K.F;Bateman,B.T;Pawar,A.;Bessette,L.G;Mogun,H.;Levin,R.;Li,H.;MoFernandes,M.F;Upadhyaya,Cohortstudy.BMJ2020,368,m237.[CrossRef]15.Einarson,A.;Fatoye,B;Sarkar,M.;Lavigne,S.V;Brochu,J;Chambers,C;MastroiaSchuler,L;etal.Pregnancyoutcomefollowicontrolledstudy.Am.J.Psychiatry2001,158,1728-1730.[CrossRef]Int.1.Environ.Res.PublicHealth2023,20,65majorcongenitalmalformations:Asystematicreview17.Richardson,J.L;Martin,F;Dunstan,H.;Greenall,A;Stephens,S.;Yates,L.M.;Thomas,S.H.L.Pregnancyoutcomesfollowingmaternalvenlafaxineuse:Aprospec19.Ankarfeldt,M.Z;Petersen,J;Andersen,J.T;Li,H.;Motsko,S.P;Fast,T;Hede,S.M.;Jimenez-SolemDenmarkandSweden.20.Ban,L.;Gibson,J.E.;West,J.;Fiaschi,L.;Sokal,R.;Smeeth,L;Doyle,P;Hubbard,R.B.;Tata,LJ.Maternaldepression,21.Simon,G.E;Cunningham,M.L;Davis,R.L.Outcomesofprenatalantide22.Pearson,K.H;Nonacs,R.M.;Viguera,A.C;Heller,V.L;Petrillo,L.F;Brandes,M.;Hennen,J;Cooutcomesfollowingprenatalexposuretoantidepressants.J.Clin.Psychiatry2007Swedishdata.Psychol.Med.2010,40,1723-1733.[CrossRef]24.DeVries,C;Gadzhanova,S;Sykes,M.J.;Ward,M.;Roughead,E.Asystematicrconsideringtheriskforcongenitalheart25.Winterfeld,U.;Klinger,G.;Panchaud,A.;Stephens,S.;Arnon,J;Malm,H.;TeWinkel,B;Clementi,M.;Pistelli,A.;Ma“náková,E.;etal.Pregnancyoutcostudy.J.Clin.Psychopharmacol.2015,35,250-259.[26.Einarson,A.;Bonari,L.;Voyer-Lavigne,S;Addis,A;Matsui,D;Johnson,Y;Koren,G.Amultcontrolledstudytodetermin48,106-110.[CrossRef][PuoutcomeofwomenexposedtGynecol.2005,192,932-9328.Djulus,J.;Koren,G.;Einarson,I.R;Wilton,L;Shakir,S;Diav-Citrin,O;Kennedy,D;Lavigne,VS;DeSantis,M.;Einarson,A.ExposuretomirtazapinPsychiatry2006,67,1280-1229.Smit,M.;Wennink,H.;Heres,M.;Dolman,K.M.;Honig,A.Mirtazapineinpregnancyandcaseseries.J.Clin.Psychopharmacol.2015,35,163-167.[CrossRef]30.Dao,K;Shechtman,S;Diav-Citrin,O;George,N.;Richardson,JL.;Rollason,V;Pistelli,A.;EleftheENTIScohortstudy.J.Clin.Psychopharmacol.2023,43,12-19.[Cross31.Alwan,S;Reefhuis,J.;Botto,L.D;Rasmussen,S.A.;CorStudy.Maternaluseofbupropionandriskforcongenitalheartdefects.Am32.Cole,J.A;Ephross,S.A.;Cosmatos,I.S.;Walker,A.M.Pcongenitalmalformations.Pharmacoepidemiol.DrugSaf.2007,16,1075-1085.[33.Bérard,A;Ramos,E;Rey,E.;Blais,L.;St-André,M.;Oraicardiacmalformationsininfants:Theimportanc34.Enato,E;Moretti,M.;Koren,G.ThefetalsafetGynaecol.Can.2011,33,46-435.Grigoriadis,S;Graves,L;Peer,M.;Mamisashvili,L.;Dennis,C.L;Vigod,S.N;Steiner,M;Brocongenitalmalformations:Systematicreviewandmeta-analysis.J.Clin.Psychiatry2019,80,1836.Wikner,B.N.;Stiller,C.O;Bergman,U.;Asker,C.;Kallén,B.Useofbagonistsduringpregnancy:Neonataloutcomeandcongenitalmalformations.Pharmacoepofnitrazepam,medazepam,tofifisopam,alprazolumandclonazepamtreatmentduringpregnancy.Eur.J.ObGynecol.Reprod.Biol.2002,101,147-154.[Cros39.Wikner,B.N.;Kallén,B.ArehypnoticPsychopharmacol.2011,31,356100.Wang,LH.;Lin,H.C;Lin,C.C;Chen,Y.H.Increasedriskofazolpidemduringpregnancy.Clin.Pharmacol.Ther.2010,88,369-374.[CrossRef][PubMed]40.Tinker,S.C;Reefhuis,J;Bitsko,R.H.;Gilboa,S.M.;Mitchell,A.A.;Tran,E.L;Werler,M.M.;Broussard,C.defects,NationalBirthDefectsPreventionStudy,1997-201141.Ban,L;West,J;Gibson,J.E.;Fiaschi,L.;Sokal,R.;Doyle,P;Hubbard,R;Smeeth,L.;Tata,LJ.Firsttrimesterexposurecohortstudy.PLoSONE.2014,9,e100996.[CrossR43.Omoy,A;Arnon,J;Shechtman,S;Moer103.Noh,Y;Lee,H.;Choi,A;Kwon,I.S;Choe,S.A.;Ch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