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Fetal impact of antidepressants

Aug. 3, 2016, 8:00 AM

Antidepressant use during pregnancy is common. Fetal exposure to the class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs) is associated with the life-threatening condition PPHN (persistent pulmonary hypertension of the newborn), but a causal link has not been established.

Premature constriction of an important fetal blood vessel, the ductus arteriosus (DA), causes PPHN. Elaine Shelton, Ph.D., and colleagues theorized that SSRIs might cause in utero constriction of the DA, leading to lung complications after birth. Using isolated blood vessels and in vivo models, the researchers demonstrated that two commonly prescribed SSRIs — fluoxetine and sertraline — cause constriction of the fetal mouse DA. The studies provide a molecular mechanism for SSRI-association DA constriction — and a potential mechanism for SSRI-associated pulmonary hypertension.

The findings, reported in the American Journal of Physiology – Heart and Circulatory Physiology, provide a rationale for using non-SSRI antidepressants during pregnancy and promote the idea of monitoring the fetal circulation of babies exposed to SSRIs.

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