Prenatal exposure to serotonin reuptake inhibitor antidepressants and offspring social behaviour

Depression during pregnancy is a major societal health issue and the prescription of antidepressants to treat the mood disorder is common practice. Since both the antenatal depression and the antidepressant used to treat the depression may affect the development of the child, it is an important question whether or not to treat the mother with antidepressants during pregnancy. Currently, 4–13% of the pregnant women in the U.S. use selective serotonin reuptake inhibitors (SSRIs) as antidepressants. SSRIs do not cause gross structural neuroteratogenic effects and are considered relatively safe. However the long-term neurodevelopmental consequences for the offspring remain largely unknown. SSRIs block the reuptake of serotonin thereby increasing extracellular levels of serotonin. Serotonin is a key neurotrophic factor and critical in fetal brain development. SSRI treatment during pregnancy may therefore have detrimental consequences for the offspring. Recently exposure to SSRIs before and during pregnancy was shown to increase the risk of autism spectrum disorders. Interestingly, children with autism spectrum disorders more likely have a mother with a history of depression, raising the question whether antenatal depression, SSRI treatment, or both are contributing to the effects seen in the offspring. In humans it is difficult to discern whether and/or to what extent the adverse effects on offspring are caused by the antenatal depression per se or caused by the pharmacological treatment of the depression.