Use of serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) during pregnancy: Effect on fetal growth and long-term reproductive outcomes
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引用次数: 0
Abstract
Anxiety and depression during pregnancy are recognized as major public health concerns. Depression and anxiety, if untreated, severely affect both mother and the fetus, especially during pregnancy. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are frequently prescribed drugs to manage above conditions during pregnancy. Although these medications affect the levels of neurotransmitters, research indicates their potential impact on development of the fetus. Studies on maternal exposure to SSRIs and SNRIs show possible risks of offspring's congenital cardiovascular abnormalities and anomalies of the kidney and digestive system. Maternal exposure to selective SSRIs and SNRIs during pregnancy has been associated with certain adverse perinatal outcomes, including preterm birth, low birth weight, and neonatal adaptation syndrome. Exposure to SSRIs and SNRIs also increases the possible risk of persistent pulmonary hypertension in the newborn. However, evidence regarding long-term neurodevelopmental outcomes remains inconclusive, with studies showing mixed results. Therefore, based on the available data, it is hypothesized that these drugs may potentially have direct or indirect effects on reproductive outcomes of the progeny. Because of the increasing occurrence of maternal depression worldwide and the consequent usage of SSRIs and SNRIs, there is an urgent need for additional data to better understand the risk of developmental toxicity related to the use of these antidepressants during pregnancy. This review, therefore, aims to examine the effects of SSRIs and SNRIs exposure during pregnancy on fetal growth, postnatal development and long-term reproductive outcomes of the progeny with regard to a careful consideration of better treatment options.
期刊介绍:
Drawing from a large number of disciplines, Reproductive Toxicology publishes timely, original research on the influence of chemical and physical agents on reproduction. Written by and for obstetricians, pediatricians, embryologists, teratologists, geneticists, toxicologists, andrologists, and others interested in detecting potential reproductive hazards, the journal is a forum for communication among researchers and practitioners. Articles focus on the application of in vitro, animal and clinical research to the practice of clinical medicine.
All aspects of reproduction are within the scope of Reproductive Toxicology, including the formation and maturation of male and female gametes, sexual function, the events surrounding the fusion of gametes and the development of the fertilized ovum, nourishment and transport of the conceptus within the genital tract, implantation, embryogenesis, intrauterine growth, placentation and placental function, parturition, lactation and neonatal survival. Adverse reproductive effects in males will be considered as significant as adverse effects occurring in females. To provide a balanced presentation of approaches, equal emphasis will be given to clinical and animal or in vitro work. Typical end points that will be studied by contributors include infertility, sexual dysfunction, spontaneous abortion, malformations, abnormal histogenesis, stillbirth, intrauterine growth retardation, prematurity, behavioral abnormalities, and perinatal mortality.