Serotonin reuptake inhibitors in pregnancy: can genes help us in predicting neonatal adverse outcome?

Area of Science:

• Perinatal Medicine
• Pharmacogenetics
• Neonatal Outcomes

Background:

• Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed during pregnancy.
• Maternal SSRI exposure is linked to various adverse neonatal outcomes, including low birth weight, respiratory distress, and neurobehavioral issues.
• The underlying mechanisms and factors influencing the variability of these outcomes remain poorly understood.

Purpose of the Study:

• To explore the potential role of pharmacogenetics in explaining differential neonatal outcomes following in utero SSRI exposure.
• To review current pharmacogenetic research concerning the maternal-fetal environment and SSRI response.

Main Methods:

• Literature review focusing on pharmacogenetic studies related to SSRI use during pregnancy.
• Synthesis of existing research on pharmacogenomic variations and their impact on neonatal health outcomes.
• Analysis of the maternal-fetal environment in the context of pharmacogenetics and SSRI exposure.

Main Results:

• Pharmacogenetics, the study of how genes affect drug response, offers a potential framework for understanding varied neonatal outcomes.
• Genetic variations in both mother and fetus may influence the metabolism and effects of SSRIs, leading to different clinical presentations.
• Current pharmacogenetic inquiries are limited but highlight the need for further investigation into gene-drug-environment interactions.

Conclusions:

• Pharmacogenetics presents a promising avenue for elucidating the mechanisms behind SSRI-associated neonatal adverse effects.
• Understanding individual genetic profiles could lead to personalized risk assessment and management strategies for pregnant individuals using SSRIs.
• Further research in maternal-fetal pharmacogenomics is crucial for optimizing perinatal care and improving neonatal health outcomes.