Objective:To compare the prevalence and clinical characteristics of neonatal abstinence syndrome in neonates exposed and not exposed to selective serotonin r euptake inhibitors(SSRIs)in utero.Design:Cohort study.Setting:Tertiary car e center.Patients:One hundred twenty term infants,of whom 60 had prolonged in utero exposure to SSRIs,including paroxetine hydrochloride,fluoxetine,citalo pram hydrobromide,sertraline hydrochloride,and venlafaxine hydrochloride.Main Outcome Measures:Neonatal abstinence syndrome was assessed with the Finnegan s core as follows:score of 8 or above,severe;score of 4 to 7,mild;and score o f 0 to 3,normal.All infants were followed up with a standardized protocol that included repeated Finnegan score assessments and cardiorespiratory monitoring u ntil normalization of the Finnegan score.Results:Of the 60 neonates exposed to SSRIs in utero,8 showed severe and 10 showed mild symptoms of a neonatal absti nence syndrome.All nonexposed neonates had a normal Finnegan score.In neonates who developed severe symptoms,the maximum mean daily Finnegan scores were reco rded within 2 days after birth,although maximum individual scores were recorded as long as 4 days after birth.Conclusions:Neonatal abstinence syndrome occurs in 30%of neonates exposed to SSRIs in utero.These neonates should be monitore d for at least 48 hours after birth.The longterm effects of prolonged exposure to SSRIs,particularly in neonates who develop severe symptoms,have yet to be d etermined. Objective: To compare the prevalence and clinical characteristics of neonatal abstinence syndrome in neonates exposed and not exposed to selective serotonin r euptake inhibitors (SSRIs) in utero. Design: Togo study. Setting: Tertiary car e center. Patients: One hundred twenty term infants , of whom 60 had prolonged in utero exposure to SSRIs, including paroxetine hydrochloride, fluoxetine, citalo pram hydrobromide, sertraline hydrochloride, and venlafaxine hydrochloride. Main Outcome Measures: Neonatal abstinence syndrome was rated with the Finnegan s core as follows: score of 8 or above, severe; score of 0 to 3, normal. All infants were followed up with a standardized protocol that included repeated Finnegan score assessments and cardiorespiratory monitoring u ntil normalization of the Finnegan score. Results: Of the 60 neonates exposed to SSRIs in utero, 8 showed severe and 10 showed mild symptoms of a neonatal abstinence syndrome. All nonexposed neonates had a normal Finnegan s core.In neonates who developed severe symptoms, the maximum mean daily Finnegan scores were reco rded within 2 days after birth, although maximum individual scores were recorded as long as 4 days after birth. Confclusions: Neonatal abstinence syndrome occurs in 30% of neonates exposed to SSRIs in utero.These neonates should be monitore d for at least 48 hours after birth. longterm effects of prolonged exposure to SSRIs, particularly in neonates who develop severe symptoms, have yet to be d etermined.