1292 Differences in Postpartum Policy After Maternal Use of Selective Serotonin-Reuptake Inhibitors During Pregnancy

Background and Aim ±10% of women has a depression during pregnancy and selective serotonin reuptake inhibitors (SSRI) are frequently used. After the use of SSRI’s approximately 30% of neonates show adverse effects. We studied different policies in the Netherlands in term neonates after maternal SSRI use and findings of standard 48-hour monitor observation and glucose testing. Methods A questionnaire about local policy in neonates after maternal SSRI use was performed in all Dutch hospitals. Next to this we describe the occurrence of incidents and hypoglycemia in a 5.5-years cohort of term neonates (n=138), in which standard monitor observation and glucose testing was performed. Results The questionnaire response rate was 79%. Standard observation is conducted in 96% of the hospitals, 77% on the maternity ward and 23% on the neonatology ward, using a monitor. The majority (n=53, 73%) observes neonates for 48 hours (range 12–72 hours). Standard glucose testing is performed in 12% of hospitals. Ambulatory follow-up is performed in 30% of hospitals. Our cohort study showed that if no incidents occurred during the first 24 hours of observation, no incidents will occur thereafter. Glucoses were below cut off value in 12% mainly at 1 hour after birth, resolving with oral feeding. Conclusions There are many differences in postnatal care for neonates born after maternal SSRI use. Based on our cohort study it seems unnecessary to prolong monitor observation after 24 hours if no incidents occurred. Standard glucose testing should not be performed.