Effects of psychotropic medications on a placenta cell model: a functional study with BeWo cells

If taken during pregnancy, some psychotropic medications may increase the risk of adverse perinatal outcomes, including reduced birth weight and small for gestational age outcome. A key factor in foetal growth and development is the placental endocrine function, with critical placental hormones including human chorionic gonadotropin (hCG), placental growth factor (PlGF), and leptin. In this in vitro study, we aimed at characterising the impact of psychotropic medications on placental endocrine function.

We focused on often used psychotropic medications at concentrations up to 30µM and including concentrations attained in blood plasma in (non-pregnant) patients. Their effects on the secretion of hCG, PlGF, and leptin were investigated in a well-established model of human trophoblasts (BeWo cells). Since intact cell viability and metabolic activity are required for hormone production, these aspects were studied beforehand.

Citalopram (at 30µM), sertraline and aripiprazole (at ≥10µM) markedly reduce cell viability, whereas quetiapine (at 30µM) slightly decreases it and diazepam and zolpidem (each up to 30µM) do not affect it. Experiments with subtoxic concentrations of the medications reveal no effects on either metabolic activity or on the production of the hormone hCG. The production of PlGF varies slightly and depending on the medication tested. Diazepam and quetiapine (at 30µM) markedly impair leptin production.

Our findings reveal marked differences in how various medications affected cell viability and hormone production. Whether these effects could be related to changes in clinical outcomes such as birth weight and small-for-gestational-age requires further investigation.