Brain imaging findings suggest selective serotonin reuptake inhibitor (SSRI) use by pregnant women may be associated with changes in fetal brain development, particularly in regions of the brain related to emotional processing.  Researchers published their results in JAMA Pediatrics.

SSRI use has increased among pregnant women, likely because of an increased awareness about the effects of untreated prenatal maternal depression on women and children. Little is known about the association between prenatal SSRI and fetal neurodevelopment in humans but animal studies suggest perinatal SSRI exposure can alter brain circuitry and produce anxiety and depressive-like behaviors after adolescence.

Researchers studied 98 infant-mother pairs (16 infants who had in utero SSRI exposure self-reported by mothers compared to 21 infants exposed in utero to untreated maternal depression and 61 other healthy infants without those exposures).  Data were collected between 2011 and 2016.

Researchers measured SSRI use and untreated maternal depression (exposures) in the pregnant mothers.  Using magnetic resonance imaging (MRI) they were able to estimate gray matter volume and white mater structural connectivity.

They found that increased volumes of the amygdala and insular cortex and increased white matter connection strength between the two regions was associated with infants who had prenatal SSRI exposure.

This was an observational study. Researchers were not intervening for purposes of the study and they cannot control natural differences that could explain the study findings.

Claudio Lugo-Candelas, Ph.D., Jiook Cha, Ph.D., and their colleagues of Columbia University Irving Medical Center, New York, and the New York State Psychiatric Institute were authors of the study.

Participants were not randomly assigned and sociodemographic differences existed between the groups.  Women who received an SSRI during pregnancy may have been more severely depressed than women with untreated prenatal maternal depression.

These findings suggest that prenatal SSRI exposure has an association with fetal brain development particularly in brain regions critical to emotional processing.  The study highlights the need for further research on the potential long-term behavioral and psychological outcomes of these neurodevelopmental changes.

This study was supported in part by the National Institute of Mental Health, the Brain & Behavior Research Foundation National Alliance for Research on Schizophrenia and Depression, the Korean-American Scientists and Engineers Association and the Edwin S Webster Foundation.