title: Antenatal depression, treatment with selective serotonin reuptake inhibitors, and neonatal brain structure: A propensity-matched cohort study.
abstract: The aim of this propensity-matched cohort study was to evaluate the impact of prenatal SSRI exposure and a history of maternal depression on neonatal brain volumes and white matter microstructure. SSRI-exposed neonates (n=27) were matched to children of mothers with no history of depression or SSRI use (n=54). Additionally, neonates of mothers with a history of depression, but no prenatal SSRI exposure (n=41), were matched to children of mothers with no history of depression or SSRI use (n=82). Structural magnetic resonance imaging and diffusion weighted imaging scans were acquired with a 3T Siemens Allegra scanner. Global tissue volumes were characterized using an automatic, atlas-moderated expectation maximization segmentation tool. Local differences in gray matter volumes were examined using deformation-based morphometry. Quantitative tractography was performed using an adaptation of the UNC-Utah NA-MIC DTI framework. SSRI-exposed neonates exhibited widespread changes in white matter microstructure compared to matched controls. Children exposed to a history of maternal depression but no SSRIs showed no significant differences in brain development compared to matched controls. No significant differences were found in global or regional tissue volumes. Additional research is needed to clarify whether SSRIs directly alter white matter development or whether this relationship is mediated by depressive symptoms during pregnancy.
authors.affiliation: Curriculum in Neurobiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
authors.forename: Shaili C
authors.initials: SC
authors.lastname: Jha
authors.affiliation: Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
authors.forename: Samantha
authors.initials: S
authors.lastname: Meltzer-Brody
authors.affiliation: Psychological Sciences, Vanderbilt University, Nasheville, TN 37240, USA.
authors.forename: Rachel J
authors.initials: RJ
authors.lastname: Steiner
authors.affiliation: Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
authors.forename: Emil
authors.initials: E
authors.lastname: Cornea
authors.affiliation: Durham VA Medical Center, Durham, NC 27705, USA.
authors.forename: Sandra
authors.initials: S
authors.lastname: Woolson
authors.affiliation: Department of Mathematics and Statistics, University of Nevada, Reno, NV 89557, USA.
authors.forename: Mihye
authors.initials: M
authors.lastname: Ahn
authors.affiliation: Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
authors.forename: Audrey R
authors.initials: AR
authors.lastname: Verde
authors.affiliation: Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Hamer
authors.affiliation: Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
authors.forename: Hongtu
authors.initials: H
authors.lastname: Zhu
authors.affiliation: Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Department of Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
authors.forename: Martin
authors.initials: M
authors.lastname: Styner
authors.affiliation: Curriculum in Neurobiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
authors.forename: John H
authors.initials: JH
authors.lastname: Gilmore
authors.affiliation: Curriculum in Neurobiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. Electronic address: rebecca_knickmeyer@med.unc.edu.
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Knickmeyer
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging* / Q000187:drug effects; D015331:Cohort Studies; D003866:Depressive Disorder / Q000188:drug therapy*; D056324:Diffusion Tensor Imaging; D005260:Female; D066128:Gray Matter / Q000000981:diagnostic imaging / Q000187:drug effects; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009929:Organ Size / Q000187:drug effects; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011297:Prenatal Exposure Delayed Effects / Q000000981:diagnostic imaging*; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D014589:Utah; D066127:White Matter / Q000000981:diagnostic imaging / Q000187:drug effects
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors
keywords: Antidepressant; Depression; Diffusion tensor imaging; Fetal development; Infant, Newborn; Magnetic resonance imaging