Fetal serotonin reuptake inhibitor antidepressant exposure: maternal and fetal factors.
Prenatal serotonin reuptake inhibitor exposure is common and neonatal outcomes vary greatly, often leading to confusion about whether to use or even continue antenatal use of these antidepressants. Importantly, some but not all infants are affected, which raises questions about how maternal drug metabolism contributes to fetal drug exposure. To address this key question, our paper reviews the role of key maternal, fetal, and placental pharmacokinetic, metabolic, and genetic factors that affect the extent of fetal drug exposure. Considering the role of these factors may further our understanding of variables that may assist in optimizing maternal psychopharmacotherapy during pregnancy and neonatal outcomes.
Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada.
Alison K
AK
Shea
Tim F
TF
Oberlander
Dan
D
Rurak
D000928:Antidepressive Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D001682:Biological Availability; D003577:Cytochrome P-450 Enzyme System / Q000235:genetics / Q000378:metabolism; D003866:Depressive Disorder / Q000188:drug therapy / Q000378:metabolism; D005260:Female; D005333:Fetus / Q000187:drug effects / Q000378:metabolism; D055106:Genome-Wide Association Study; D006801:Humans; D008658:Inactivation, Metabolic / Q000235:genetics; D008431:Maternal-Fetal Exchange; D010597:Pharmacogenetics; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000378:metabolism; D011297:Prenatal Exposure Delayed Effects / Q000235:genetics / Q000378:metabolism; D018570:Risk Assessment; D017367:Selective Serotonin Reuptake Inhibitors / Q000493:pharmacokinetics / Q000627:therapeutic use
D000928:Antidepressive Agents; D003577:Cytochrome P-450 Enzyme System; D017367:Selective Serotonin Reuptake Inhibitors