Vortioxetine Exposure During Pregnancy and Lactation: A Japanese Case Study of Neonatal Implications and Quantitative Milk and Plasma Analyses.

IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Breastfeeding Medicine Pub Date : 2024-08-01 Epub Date: 2024-05-10 DOI:10.1089/bfm.2024.0005
Mio Kiribayashi, Tetsufumi Suda, Masahiro Takahashi, Mao Ishikawa, Rena Watanabe, Kasumi Ishioka, Sayo Nakamura, Akifumi Kushiyama
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Abstract

Background: Information about influences of vortioxetine on pregnant women and neonates during perinatal period is almost unknown. Case Presentation: The case was a 28-year-old Japanese woman in her first pregnancy, treated for depression with vortioxetine (20 mg daily) among other medications. At 36 weeks of gestation, she was admitted for premature rupture of the membranes and delivered a girl with no apparent congenital anomalies. Immediately after birth, the neonate required brief respiratory support due to her dyspnea and poor muscle tone. Her respiratory condition improved in 6 days after delivery, and she demonstrated normal developmental progress afterward. Maternal plasma and breast milk samples, collected 4 days postpartum, revealed vortioxetine concentrations of 11.4 ng/mL and 9.3 ng/mL, respectively. The calculated relative infant dose (RID) was estimated at 0.32%. After discharge from hospital, the infant presented no detectable drug-related adverse effects, with over 50% of nutrition derived from breastfeeding. Conclusion: This case showed minimal transfer of vortioxetine into breast milk, reflected in a low RID. The findings suggest limited neonatal exposure to the drug, with no adverse developmental effects observed in the infant. However, the case also indicated the potential for vortioxetine use during pregnancy to contribute to the onset of severe neonatal asphyxia. Further research is needed for a comprehensive understanding of its impact on neonatal health.

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孕期和哺乳期的伏替西汀暴露:一项关于新生儿影响以及乳汁和血浆定量分析的日本案例研究。
背景有关伏替西汀在围产期对孕妇和新生儿影响的信息几乎无人知晓。病例介绍:该病例是一名 28 岁的日本妇女,她是第一次怀孕,因抑郁症接受了伏替西汀(每天 20 毫克)和其他药物治疗。妊娠 36 周时,她因胎膜早破入院,产下一名女孩,无明显先天畸形。新生儿出生后,由于呼吸困难和肌张力差,需要短暂的呼吸支持。产后 6 天,她的呼吸状况有所改善,之后发育正常。产后 4 天采集的母体血浆和母乳样本显示,伏替西汀的浓度分别为 11.4 纳克/毫升和 9.3 纳克/毫升。计算得出的婴儿相对剂量(RID)估计为 0.32%。出院后,婴儿没有出现与药物相关的不良反应,50% 以上的营养来自母乳喂养。结论本病例显示伏替西汀极少转移到母乳中,RID 很低。研究结果表明,新生儿接触该药物的机会有限,未观察到对婴儿发育的不良影响。不过,该病例也表明,孕期使用伏替西汀有可能导致新生儿重度窒息的发生。要全面了解伏替西汀对新生儿健康的影响,还需要进一步的研究。
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来源期刊
Breastfeeding Medicine
Breastfeeding Medicine OBSTETRICS & GYNECOLOGY-PEDIATRICS
CiteScore
4.20
自引率
11.10%
发文量
130
审稿时长
6-12 weeks
期刊介绍: Breastfeeding Medicine provides unparalleled peer-reviewed research, protocols, and clinical applications to ensure optimal care for mother and infant. The Journal answers the growing demand for evidence-based research and explores the immediate and long-term outcomes of breastfeeding, including its epidemiologic, physiologic, and psychological benefits. It is the exclusive source of the Academy of Breastfeeding Medicine protocols. Breastfeeding Medicine coverage includes: Breastfeeding recommendations and protocols Health consequences of artificial feeding Physiology of lactation and biochemistry of breast milk Optimal nutrition for the breastfeeding mother Breastfeeding indications and contraindications Managing breastfeeding discomfort, pain, and other complications Breastfeeding the premature or sick infant Breastfeeding in the chronically ill mother Management of the breastfeeding mother on medication Infectious disease transmission through breast milk and breastfeeding The collection and storage of human milk and human milk banking Measuring the impact of being a “baby-friendly” hospital Cultural competence and cultural sensitivity International public health issues including social and economic issues.
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