XXXX transfer across the placenta during pregnancy and into milk during lactation.

@entity1 @entity308 @entity4480
OBJECTIVE: @entity4480 is an efficacious antidepressant; however, its safety during the perinatal period is uncertain. The objective of this study was to assess the transfer across the placenta and provide data on @entity1 exposure to @entity4480 via breast milk. METHODS: A multiparous 31-year-old @entity1 with recurrent @entity308 had responded poorly to previous antidepressants, but had a full remission on @entity4480 . She elected to remain on @entity4480 for her third pregnancy and while breastfeeding. She gave birth to a healthy term @entity1 and there were no adverse events noted for the @entity1 exposed to @entity4480 . @entity4480 concentration was measured chromatographically in maternal and infant serum collected at birth, and in maternal milk and plasma and @entity1 plasma 18 days later, (C/M) concentration ratio was calculated. Absolute and relative @entity1 doses via milk were estimated and the percent drug in @entity1 versus mother's plasma was calculated. RESULTS: Cord/maternal serum concentration ratio for @entity4480 was 0.12. Absolute @entity1 dose via milk was 7.6  g/L and relative @entity1 dose was 0.81%. The ratio of drug in the @entity1 's plasma to that in maternal plasma during lactation also gave a 0.82% @entity1 exposure estimate. CONCLUSIONS: The low C/M ratio suggests a limited transfer across the placenta. The relative @entity1 dose via milk was low by comparison to most other antidepressants, and this estimate confirmed the amount of drug in @entity1 plasma during lactation. Our data suggest that @entity4480 may be used in pregnancy and lactation for selected @entity1 in whom other antidepressants have not been successful.
