title: Placental Barrier and Autism Spectrum Disorders: The Role of Prolactin and Dopamine on the Developing Fetal Brain.
abstract: Dopamine and prolactin exhibit opposite effects on lactation. However, a possible role for increased prolactin/dopamine ratio in postpartum mood and thought disorders and as a prognostic indicator of the mother's future mental health has not been well investigated. Postpartum depression is a serious condition with potentially devastating outcomes for both the mother and the infant. Early detection and treatment of this condition can have impressive results. Treatment options include antidepressant medications for mood disorders and use of antipsychotics and electroconvulsive therapy to address postpartum psychosis. Although there are obvious benefits of such treatments on the welfare of the mother and her child, broader implications of these treatments on lactation and child growth and development are not known. This review article explores a possible link between in-utero exposure to a high maternal prolactin/dopamine ratio and subsequent development of autism spectrum disorders. We hypothesize that a comprehensive, biologically oriented approach to the use of psychotropics in the regulation of neurotransmission during pre- and postpartum periods may result in better outcomes in this population.
authors.affiliation: Dr. Yarlagadda is Chief of Psychiatry, Behavioral Health Services, McDonald Army Health Center, Fort Eustis, Virginia; Dr. Acharya is Professor of Obstetrics and Gynecology, UiT-The Arctic University of Norway, Consultant Obstetrician and Gynecologist, University Hospital of North Norway, Tromsø, Norway, and Visiting Professor of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden; Dr. Kasaraneni is with Norton Healthcare, Louisville, Kentucky; Dr. Hampe is Associate Professor of Medicine, Department of Medicine, University of Washington, Seattle, Washington; and Dr. Clayton is Professor and Chair, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia.
authors.forename: Atmaram
authors.initials: A
authors.lastname: Yarlagadda
authors.affiliation: Dr. Yarlagadda is Chief of Psychiatry, Behavioral Health Services, McDonald Army Health Center, Fort Eustis, Virginia; Dr. Acharya is Professor of Obstetrics and Gynecology, UiT-The Arctic University of Norway, Consultant Obstetrician and Gynecologist, University Hospital of North Norway, Tromsø, Norway, and Visiting Professor of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden; Dr. Kasaraneni is with Norton Healthcare, Louisville, Kentucky; Dr. Hampe is Associate Professor of Medicine, Department of Medicine, University of Washington, Seattle, Washington; and Dr. Clayton is Professor and Chair, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia.
authors.forename: Ganesh
authors.initials: G
authors.lastname: Acharya
authors.affiliation: Dr. Yarlagadda is Chief of Psychiatry, Behavioral Health Services, McDonald Army Health Center, Fort Eustis, Virginia; Dr. Acharya is Professor of Obstetrics and Gynecology, UiT-The Arctic University of Norway, Consultant Obstetrician and Gynecologist, University Hospital of North Norway, Tromsø, Norway, and Visiting Professor of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden; Dr. Kasaraneni is with Norton Healthcare, Louisville, Kentucky; Dr. Hampe is Associate Professor of Medicine, Department of Medicine, University of Washington, Seattle, Washington; and Dr. Clayton is Professor and Chair, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia.
authors.forename: Jayaprada
authors.initials: J
authors.lastname: Kasaraneni
authors.affiliation: Dr. Yarlagadda is Chief of Psychiatry, Behavioral Health Services, McDonald Army Health Center, Fort Eustis, Virginia; Dr. Acharya is Professor of Obstetrics and Gynecology, UiT-The Arctic University of Norway, Consultant Obstetrician and Gynecologist, University Hospital of North Norway, Tromsø, Norway, and Visiting Professor of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden; Dr. Kasaraneni is with Norton Healthcare, Louisville, Kentucky; Dr. Hampe is Associate Professor of Medicine, Department of Medicine, University of Washington, Seattle, Washington; and Dr. Clayton is Professor and Chair, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia.
authors.forename: Christiane S
authors.initials: CS
authors.lastname: Hampe
authors.affiliation: Dr. Yarlagadda is Chief of Psychiatry, Behavioral Health Services, McDonald Army Health Center, Fort Eustis, Virginia; Dr. Acharya is Professor of Obstetrics and Gynecology, UiT-The Arctic University of Norway, Consultant Obstetrician and Gynecologist, University Hospital of North Norway, Tromsø, Norway, and Visiting Professor of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden; Dr. Kasaraneni is with Norton Healthcare, Louisville, Kentucky; Dr. Hampe is Associate Professor of Medicine, Department of Medicine, University of Washington, Seattle, Washington; and Dr. Clayton is Professor and Chair, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia.
authors.forename: Anita H
authors.initials: AH
authors.lastname: Clayton
keywords: Placenta; autism spectrum disorders (ASD); dopamine; fetal brain; gabapentin; gene expression; oxytocin; prolactin