Here, I present two studies I read this morning concerning the connection between prenatal SSRI exposure and adverse perinatal outcomes. selective serotonin reuptake inhibitor drugs (SSRIs) are widely used for a range of psychiatric ailments from depression to anxiety and work by regulating the concentration of serotonin molecules in the synapses between neurons. Serotonin is a neurotransmitter that plays a large role in mood, appetite, and sleep regulation, and also in fetal development, particularly in the development of the heart. This is why many scientific studies have linked early pregnancy SSRI exposure to cardiac malformations.
First to be discussed, the findings of an Australian research team concerning neonatal seizures for babies exposed to SSRIs in pregnancy. In their study titled, “Neonatal seizures from in utero venlafaxine exposure.” and published in Journal of Paediatrics and Child Health (November 2006), RK Pakalapati et al. write “We present a report of two infants with neonatal seizures attributed to maternal use of venlafaxine.” To be clear, venlafaxine is the chemical name for the popular antidepressant, Effexor.
The team continues, “The first infant was hypotonic and required resuscitation at birth. The second was born in a good condition but developed clinically apparent seizures after the second day of life.”
Stating that “Other causes of neonatal seizures were excluded and neurological investigations on these two infants were unremarkable”, Pakalapati et al. (2006) suggested that “all infants exposed to maternal venlafaxine, no matter their condition at birth, be monitored in hospital for at least 3 to 4 days in order to preempt and treat adverse neurological events.”
Next, a study that demonstrates the presence of SSRIs in amniotic fluid. It has long been known that SSRIs may cross the placenta, but here we see SSRIs may access fetus, if you will, by other means. In this article titled “Antidepressants in amniotic fluid: another route of fetal exposure.” by AM Loughhead et al., appearing in American Journal of Psychiatry, this team of researchers from Emory University School of Medicine studied amniotic fluid from 27 women, finding that “the amniotic fluid’s antidepressant concentrations were highly variable. For the parent compounds, the amniotic fluid concentrations of selective serotonin uptake inhibitors averaged 11.6% (SD=9.9%) of maternal serum concentrations (N=22). Amniotic fluid to maternal serum ratios were higher for venlafaxine: 172% (SD=91%) (N=3).”
As such, the team writes, “The pattern of antidepressant concentrations in amniotic fluid is similar to recent data for placental passage. Although the significance of amniotic fluid exposure remains to be determined, these results demonstrate that maternally administered antidepressants are accessible to the fetus in a manner not previously appreciated.”
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