Neonates With In-Utero SSRI Exposure (NeoWISE): a retrospective cohort study examining the effect of newborn feeding method on newborn withdrawal

Introduction Up to 30% of newborns with in-utero selective serotonin reuptake inhibitor (SSRI) exposure experience withdrawal symptoms. The impact of newborn feeding method on alleviating withdrawal has not been investigated. We examined the effect of newborn feeding method (breastfeeding versus fo...

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Main Authors: Christina Cantin, Wenbin Li, Erna Snelgrove-Clarke, Daniel Corsi, Cindy-Lee Dennis, Amanda Ross-White, Susan Brogly, Laura Gaudet
Format: Article
Language:English
Published: Swansea University 2024-12-01
Series:International Journal of Population Data Science
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Online Access:https://ijpds.org/article/view/2458
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author Christina Cantin
Wenbin Li
Erna Snelgrove-Clarke
Daniel Corsi
Cindy-Lee Dennis
Amanda Ross-White
Susan Brogly
Laura Gaudet
author_facet Christina Cantin
Wenbin Li
Erna Snelgrove-Clarke
Daniel Corsi
Cindy-Lee Dennis
Amanda Ross-White
Susan Brogly
Laura Gaudet
author_sort Christina Cantin
collection DOAJ
description Introduction Up to 30% of newborns with in-utero selective serotonin reuptake inhibitor (SSRI) exposure experience withdrawal symptoms. The impact of newborn feeding method on alleviating withdrawal has not been investigated. We examined the effect of newborn feeding method (breastfeeding versus formula) among a cohort of Neonates With In-utero SSRI Exposure (NeoWISE). Methods This population-based retrospective cohort study included newborns born in Ontario hospitals between April 1, 2012, and March 31, 2020 to Ontario Drug Benefit Program beneficiaries who filled at least one SSRI prenatal prescription. Linked administrative health and registry data were used. Method of newborn feeding was available from birth to hospital discharge. The primary outcome was newborn withdrawal. The secondary outcome was transfer to the Neonatal Intensive Care Unit (NICU). Adjusted risk ratios (adjRR) in breast- versus formula-fed newborns and our outcomes were estimated using generalized linear models. Propensity scores based on antepartum and intrapartum characteristics and inverse probability of treatment weighting were used to balance differences in maternal-newborn characteristics by treatment. Results Overall, 5,079 newborns were included in the NeoWISE Cohort, with 3,321 (65.4%) exclusively breastfeeding from birth to hospital discharge. Among the breastfed newborns, 50 (1.5%) had neonatal withdrawal versus 41 (2.3%) in the formula-fed newborns. There was no difference in risk of withdrawal in breast versus formula-fed newborns (adjRR 0.86, 95% CI 0.56, 1.34). Breastfed newborns had a reduced risk of transfer to the NICU compared to formula-fed newborns (adjRR 0.80, 95% CI 0.66, 0.97); however, this finding did not persist in sensitivity analysis. Conclusion The rate of newborn withdrawal was low in this cohort of SSRI-exposed neonates and was not associated with feeding method in the hospital. The results of this study inform shared decision-making around newborn feeding for perinatal women who take SSRI medications.
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spelling doaj-art-a71f3f2347344c1eb560c2c0a3da9df12024-12-21T10:33:03ZengSwansea UniversityInternational Journal of Population Data Science2399-49082024-12-019210.23889/ijpds.v9i2.2458Neonates With In-Utero SSRI Exposure (NeoWISE): a retrospective cohort study examining the effect of newborn feeding method on newborn withdrawalChristina Cantin0https://orcid.org/0000-0002-1535-5520Wenbin Li1https://orcid.org/0000-0001-9122-4111Erna Snelgrove-Clarke2https://orcid.org/0000-0003-3809-3305Daniel Corsi3https://orcid.org/0000-0001-7063-3354Cindy-Lee Dennis4https://orcid.org/0000-0002-0135-7242Amanda Ross-White5https://orcid.org/0000-0003-4737-0968Susan Brogly6Laura Gaudet7https://orcid.org/0000-0002-7527-5354School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada; CHEO Research Institute, Ottawa, Ontario, CanadaICES, Queen's University, Kingston, Ontario, CanadaSchool of Nursing, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada; Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, Ontario, CanadaOMNI Research Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Better Outcomes Registry and Network (BORN), Ottawa, Ontario, CanadaUniversity of Toronto, Lawrence S. Bloomberg, Faculty of Nursing, Toronto, Ontario, CanadaQueen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, Ontario, Canada; Queen's University Library, Queen's University, Kingston, Ontario, CanadaICES, Queen's University, Kingston, Ontario, Canada; Queen's University, Department of Surgery, Kingston, Ontario, CanadaSchool of Medicine, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada; Department of Obstetrics & Gynaecology, Maternal-Fetal Medicine, Kingston Health Sciences Centre, Kingston, Ontario, Canada Introduction Up to 30% of newborns with in-utero selective serotonin reuptake inhibitor (SSRI) exposure experience withdrawal symptoms. The impact of newborn feeding method on alleviating withdrawal has not been investigated. We examined the effect of newborn feeding method (breastfeeding versus formula) among a cohort of Neonates With In-utero SSRI Exposure (NeoWISE). Methods This population-based retrospective cohort study included newborns born in Ontario hospitals between April 1, 2012, and March 31, 2020 to Ontario Drug Benefit Program beneficiaries who filled at least one SSRI prenatal prescription. Linked administrative health and registry data were used. Method of newborn feeding was available from birth to hospital discharge. The primary outcome was newborn withdrawal. The secondary outcome was transfer to the Neonatal Intensive Care Unit (NICU). Adjusted risk ratios (adjRR) in breast- versus formula-fed newborns and our outcomes were estimated using generalized linear models. Propensity scores based on antepartum and intrapartum characteristics and inverse probability of treatment weighting were used to balance differences in maternal-newborn characteristics by treatment. Results Overall, 5,079 newborns were included in the NeoWISE Cohort, with 3,321 (65.4%) exclusively breastfeeding from birth to hospital discharge. Among the breastfed newborns, 50 (1.5%) had neonatal withdrawal versus 41 (2.3%) in the formula-fed newborns. There was no difference in risk of withdrawal in breast versus formula-fed newborns (adjRR 0.86, 95% CI 0.56, 1.34). Breastfed newborns had a reduced risk of transfer to the NICU compared to formula-fed newborns (adjRR 0.80, 95% CI 0.66, 0.97); however, this finding did not persist in sensitivity analysis. Conclusion The rate of newborn withdrawal was low in this cohort of SSRI-exposed neonates and was not associated with feeding method in the hospital. The results of this study inform shared decision-making around newborn feeding for perinatal women who take SSRI medications. https://ijpds.org/article/view/2458Selective Serotonin Reuptake InhibitorsPregnancyBreastfeedingLactationPoor Neonatal Adaptation SyndromeNewborn withdrawal
spellingShingle Christina Cantin
Wenbin Li
Erna Snelgrove-Clarke
Daniel Corsi
Cindy-Lee Dennis
Amanda Ross-White
Susan Brogly
Laura Gaudet
Neonates With In-Utero SSRI Exposure (NeoWISE): a retrospective cohort study examining the effect of newborn feeding method on newborn withdrawal
International Journal of Population Data Science
Selective Serotonin Reuptake Inhibitors
Pregnancy
Breastfeeding
Lactation
Poor Neonatal Adaptation Syndrome
Newborn withdrawal
title Neonates With In-Utero SSRI Exposure (NeoWISE): a retrospective cohort study examining the effect of newborn feeding method on newborn withdrawal
title_full Neonates With In-Utero SSRI Exposure (NeoWISE): a retrospective cohort study examining the effect of newborn feeding method on newborn withdrawal
title_fullStr Neonates With In-Utero SSRI Exposure (NeoWISE): a retrospective cohort study examining the effect of newborn feeding method on newborn withdrawal
title_full_unstemmed Neonates With In-Utero SSRI Exposure (NeoWISE): a retrospective cohort study examining the effect of newborn feeding method on newborn withdrawal
title_short Neonates With In-Utero SSRI Exposure (NeoWISE): a retrospective cohort study examining the effect of newborn feeding method on newborn withdrawal
title_sort neonates with in utero ssri exposure neowise a retrospective cohort study examining the effect of newborn feeding method on newborn withdrawal
topic Selective Serotonin Reuptake Inhibitors
Pregnancy
Breastfeeding
Lactation
Poor Neonatal Adaptation Syndrome
Newborn withdrawal
url https://ijpds.org/article/view/2458
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