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Neonatal Adverse Reactions After In Utero Exposure to Selective Serotonin Reuptake Inhibitors: Still Controversial—Reply

Gil Klinger, MD; Rachel Levinson-Castiel, MD; Paul Merlob, MD
Arch Pediatr Adolesc Med. 2006;160(8):855-856. doi:10.1001/archpedi.160.8.856.
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We read with interest the letter by Beaulac-Baillargeon and Boucher regarding our article1 on NAS following in utero exposure to SSRIs in term infants.

Our study clearly showed that 30% of infants exposed to SSRIs had symptoms of NAS as measured by the Finnegan score and that the symptoms were related to SSRI exposure because they were absent in nonexposed infants. The Finnegan score is an objective method used to monitor onset, progression, and improvement of NAS symptoms in passively exposed infants. Although the Finnegan score was designed for assessment of opiate withdrawal, NAS scores have been similarly used for SSRI-exposed infants.2,3 This score captures most NAS symptoms; however, we observed in some infants, and especially in preterm infants, additional symptoms such as hypotonia, decreased activity, and weak cry as Beaulac-Baillargeon and Boucher also report. Inclusion of these additional symptoms would probably increase the accuracy of NAS assessment.

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