Prenatal SSRI Exposure and the Fetal Brain

Apr 14, 2018
Study Examines Associations of Prenatal SSRI Exposure, Fetal Brain Development

Bottom Line: Brain imaging findings suggest selective serotonin reuptake inhibitor (SSRI) use by pregnant women may be associated with changes in fetal brain development, particularly in regions of the brain related to emotional processing.

Why The Research Is Interesting: SSRI use has increased among pregnant women, likely because of an increased awareness about the effects of untreated prenatal maternal depression on women and children. Little is known about the association between prenatal SSRI and fetal neurodevelopment in humans but animal studies suggest perinatal SSRI exposure can alter brain circuitry and produce anxiety and depressive-like behaviors after adolescence.

Who and When: 98 infant-mother pairs (16 infants who had in utero SSRI exposure self-reported by mothers compared to 21 infants exposed in utero to untreated maternal depression and 61 other healthy infants without those exposures); data were collected between 2011 and 2016

What (Study Measures): SSRIs and untreated maternal depression (exposures); estimates of gray matter volume and white matter structural connectivity using magnetic resonance imaging (MRI)

How (Study Design): This was an observational study. Researchers were not intervening for purposes of the study and they cannot control natural differences that could explain the study findings.

Authors: Jiook Cha, Ph.D., of Columbia University Irving Medical Center, New York, and coauthors

Results: Increased volumes of the amygdala and insular cortex and increased white matter connection strength between the two regions was associated with infants who had prenatal SSRI exposure.

Study Limitations: Participants were not randomly assigned; women who received an SSRI during pregnancy may have been more severely depressed than women with untreated prenatal maternal depression; and sociodemographic differences existed between the groups

Study Conclusions:

Our Findings suggest that prenatal SSRI exposure has an association with fetal brain development, particularly in brain regions critical to emotional processing. The study highlights the need for further research on the potential long-term behavioural and psychological outcomes of these neurodevelopmental changes.

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(doi:10.1001/jamapediatrics.2017.5227)