This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.The treatment of depressive and anxiety disorders in women during pregnancy has become a topic of increasing controversy. Recent studies have reported that there are neonatal complications associated with the use of the most common forms of antidepressants, the serotonin reuptake inhibitors (SSRIs). These complications have ranged from the neonatal adaptation syndrome, which appears to be self-limited, to problems with greater morbidity and mortality, such as prematurity and persistent pulmonary hypertension of the newborn. The decision to treat or not to treat with antidepressant medication during pregnancy has become even more complicated by recent reports showing that women who discontinue these medications have significant risk of relapse of major depression. Major depression and anxiety disorders during pregnancy may have their own independent risks to the fetus. Thus, clarifying the neonatal risks associated with antidepressant medications has become a crucial research question, in order to weigh the risks and benefits of psychopharmacologic treatment during pregnancy.Thus far, no studies have been completed in the United States that have focused upon assessing the rates of psychotropic use in mothers whose infants are admitted to the neonatal intensive care unit or special care nurseries. Unfortunately, many of the SSRI outcome studies have excluded premature infants or infants with neurological complications from data analysis. The prevalence of psychotropic medication use in mothers of infants born prematurely, with neurological complications or other medical problems, has not been investigated. Therefore, we propose to assess the rates of psychotropic drug use in mothers of neonates admitted to the Stanford neonatal special care nurseries, including the Neonatal Intensive Care Nursery (NICU) and Packard Special Care Nursery (PCSN). We seek to compare the rates and types of complications in neonates exposed to and not exposed to these psychotropic medications.
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