Prenatal Antidepressant Exposure and the Developing Brain: A Review of Neuroimaging Findings

Antenatal mood disturbances are experienced by as many as 20% of pregnant mothers and are commonly treated with serotonin reuptake inhibitor (SRI) antidepressants. Both maternal depression and SRIs during pregnancy are associated with low birth weight and infant neurobehavioral disturbances, as well as longer-term impacts on child neurodevelopment, behavior, and mental health. As maternal depression and its pharmacotherapy are inherently interrelated prenatal exposures, distinguishing how these early life factors uniquely impact child development remains methodologically challenging. Over the past several years, however, advanced neuroimaging has been successfully used to identify neural correlates of prenatal depression and SRI antidepressant exposure on the developing brain, extending from the early newborn period through adolescence. In this review, we examine the use of magnetic resonance imaging and electroencephalography to study child brain structure or function, with a specific focus on prenatal antidepressants as the primary exposure in relation to either typical development or exposure to maternal depressed mood alone. We include both cross-sectional and longitudinal neuroimaging studies, as well as those that link early brain findings with cognitive or behavioral outcome in childhood. We also discuss factors that may shape neurodevelopmental risk (e.g., maternal mental illness severity, sex differences, genetic variability) and present suggestions for future research that will advance our understanding of child brain development in the context of maternal mood disturbances during pregnancy.