Sertraline use during pregnancy and effect on fetal cardiac function

Area of Science:

• Perinatal cardiology
• Pharmacology
• Maternal-fetal medicine

Background:

• Selective serotonin reuptake inhibitors (SSRIs) like sertraline are commonly prescribed during pregnancy.
• Understanding the potential impact of maternal SSRI use on fetal development is crucial.

Purpose of the Study:

• To evaluate and compare fetal cardiac function in pregnancies exposed to sertraline versus unexposed pregnancies.
• To assess specific cardiac parameters including Myocardial Performance Index (MPI) and E/A ratios.

Main Methods:

• A cohort study involving 44 pregnant women between 25 and 26 weeks of gestation.
• Fifteen women received daily sertraline (50-150 mg), while 29 received no daily medication.
• Fetal cardiac function was assessed using Myocardial Performance Index (MPI), E/A ratios, tricuspid annular plane systolic excursion (TAPSE), and mitral annular plane systolic excursion (MAPSE) via 2D and 4D echocardiography.

Main Results:

• No statistically significant differences were observed in MPI, E/A ratios, TAPSE, or MAPSE between the sertraline-exposed and unexposed groups.
• Specific mean differences for MPI, E/A ratios, TAPSE, and MAPSE were reported with their respective confidence intervals, all indicating no significant variation.
• Serum sertraline levels in the exposed group ranged from 33-266 nmol/L, with a median of 92 nmol/L.

Conclusions:

• Maternal exposure to sertraline during mid-pregnancy does not appear to significantly alter fetal cardiac function.
• Key echocardiographic measures of fetal cardiac performance (TAPSE, MAPSE, MPI, E/A ratios) showed no differences between exposed and unexposed fetuses.
• These findings suggest that sertraline use in pregnancy may not adversely affect fetal cardiac development based on the assessed parameters.