title: Third trimester fetal heart rate and Doppler middle cerebral artery blood flow velocity characteristics during prenatal selective serotonin reuptake inhibitor exposure.
abstract: Prenatal selective serotonin reuptake inhibitor (SSRI) exposure increases the risk for adverse neonatal behavioral outcomes; although it is unknown whether altered brain function is present before birth. We investigated fetal vascular and heart rate changes at 36-wk gestation in SSRI-treated women with mood disorders (n = 29) [exposed (EXP)] and controls (n = 45) [non-EXP (NEXP)]. Fetal middle cerebral artery (MCA) flow parameters and heart rate characteristics were obtained during pre-SSRI dose morning and postdose afternoon sessions. Maternal mood and cord Hb and hematocrit were measured. Basal fetal heart rate (fHR) did not differ between groups or across the day. The fHR short- and long-term variations, accelerations, and duration of high variability episodes remained lower and did not change across the day in EXP, whereas all increased significantly in NEXP. In both groups, MCA flow velocity and volume flow increased significantly across the day. EXP MCA pulsatility index was significantly lower, as was MCA cross-sectional area. EXP cord Hb and hematocrit were significantly increased. Prenatal SSRI exposure reduced fetal MCA flow resistance and fHR variability, before and after an SSRI dose, controlling for maternal mood. These changes and the SSRI-related increased red cell indices suggest possible fetal hypoxia.
authors: Department of Obstetrics & Gynecology, Child & Family Research Institute, University of British Columbia, Vancouver, British Columbia, Canada. drurak@cw.bc.ca
authors: Dan
authors: D
authors: Rurak
authors: Ken
authors: K
authors: Lim
authors: Ari
authors: A
authors: Sanders
authors: Ursula
authors: U
authors: Brain
authors: Wayne
authors: W
authors: Riggs
authors: Tim F
authors: TF
authors: Oberlander
mesh_terms: D000328:Adult; D000339:Affect / Q000187:drug effects; D001955:British Columbia; D016022:Case-Control Studies; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D016009:Chi-Square Distribution; D005260:Female; D005312:Fetal Blood / Q000378:metabolism; D005318:Fetal Heart / Q000187:drug effects*; D005311:Fetal Hypoxia / Q000097:blood / Q000139:chemically induced* / Q000503:physiopathology; D006400:Hematocrit; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D018811:Maternal Exposure; D008431:Maternal-Fetal Exchange; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000187:drug effects*; D019964:Mood Disorders / Q000188:drug therapy* / Q000523:psychology; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D018570:Risk Assessment; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D017585:Ultrasonography, Doppler, Transcranial
chemical_list: D006454:Hemoglobins; D017367:Selective Serotonin Reuptake Inhibitors