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Fluoxetine during pregnancy: impact on fetal development
Janna L Morrison1, K Wayne Riggs, Dan W Rurak
1Discipline of Physiology, School of Molecular and Biomedical Science, Centre for the Early Origins of Adult Disease, University of Adelaide, Australia. janna.morrison@adelaide.edu.au
Reproduction, Fertility, and Development
|November 3, 2005
Summary
Antidepressant fluoxetine (FX) exposure in pregnant sheep fetuses reduced oxygen and nutrient flow, potentially impacting fetal growth and neurodevelopment. Further research is needed to understand long-term effects of SSRI exposure on offspring development.
Area of Science:
- Perinatal pharmacology
- Fetal development research
- Neuroscience
Background:
- Selective serotonin reuptake inhibitors (SSRIs), like fluoxetine (FX), are frequently prescribed during pregnancy due to fewer side effects compared to other antidepressants.
- Clinical studies indicate potential adverse neonatal outcomes following in utero exposure to FX.
- Understanding the physiological impact of maternal antidepressant use on fetal development is crucial.
Purpose of the Study:
- To investigate the physiological effects of in utero fluoxetine (FX) exposure on fetal development using a sheep model.
- To explore potential mechanisms linking FX exposure to adverse birth outcomes observed in human clinical studies.
Main Methods:
- Utilized an 8-day infusion of fluoxetine (FX) in late-gestation sheep to model in utero exposure.
- Conducted serial blood sampling in mother and fetus to analyze drug disposition.
- Monitored fetal behavioral state and cardiovascular function throughout the study.
Main Results:
- Fluoxetine (FX) exposure acutely increased maternal plasma serotonin, causing transient uterine blood flow reduction, potentially limiting fetal oxygen and nutrient supply.
- In utero FX exposure increased fetal high-voltage/non-rapid eye movement behavioral state, suggesting interference with normal neurodevelopment.
- Fetal FX exposure amplified the prepartum rise in fetal cortisol but did not alter fetal circadian rhythms of melatonin or prolactin.
Conclusions:
- In utero fluoxetine (FX) exposure in sheep presents a physiological mechanism for reduced fetal growth and preterm delivery.
- FX exposure may negatively impact fetal neurodevelopment by altering behavioral states and hypothalamic-pituitary-adrenal axis function.
- Further long-term studies in both animal models and humans are necessary to fully understand the consequences of in utero SSRI exposure.