Fetal Effects of In Utero Serotonin Reuptake Inhibitor (SRI) Antidepressant Exposure

Abstract

In utero serotonin reuptake inhibitor (SRI) exposure is relatively common and neonatal behavioral outcomes vary greatly. Such exposure has led to questions about whether these effects refl ect an acute short-lived pharmacological phenomenon that results in a "withdrawal" condition, or sustained neurological changes associated with altered serotonin (5-HT) signaling that begins long before birth. Emerging reports now suggest that certain effects associated with in utero SRI exposure become evident during gestation. For instance, in utero SRI exposure appears to infl uence fetal brain blood fl ow and neurobehavior. In this chapter, we summarize current research evidence reporting the fetal effects of in utero SRI exposure. Given the paucity of empiric fetal data in humans, we draw from what we know about three postnatal fi ndings that may refl ect fetal developmental sequelae associated with in utero SRI exposure.