Prenatal SSRI Exposure May Affect Brain Development

Researchers have found a significant association between prenatal exposure to selective serotonin reuptake inhibitors (SSRIs) and brain development, with infants exposed to SSRIs showing expanded gray matter and higher white matter structural connectivity among the insula and amygdala, according to a study recently published in JAMA Pediatrics.

This cohort study included 98 mothers (32% white, 27% black, 27% Latina, 15% other). The mean age of their infants was 3.43 weeks (standard deviation 1.50), with 47% boys and 53% girls.

Out of all of the infants, 21 had in utero exposure to untreated maternal depression, 16 had in utero exposure to SSRIs, and 61 were part of a healthy control group. Infants exposed to SSRIs displayed a significant expansion in gray matter in the right insula (Cohen d =.86) and right amygdala (Cohen d =.65) compared with the other 2 groups (P <.05; whole-brain correction).

Using connectome-level analysis, researchers also found that infants exposed to SSRIs displayed significantly increased white matter structural connectivity between the right insula and right amygdala (d =.99) in comparison with the other 2 groups (P <.05; whole connectome correction).

This study is limited by several factors, including sample differences due to a lack of random assignment, as well as social demographic differences in the sample group.

Researchers conclude 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.”

Reference

Lugo-Candelas C, Cha J, Hong S, et al. Associations between brain structure and connectivity in infants and exposure to selective serotonin reuptake inhibitors during pregnancy [published online April 9, 2018]. JAMA Pediatr. doi: 10.1001/jamapediatrics.2017.5227