title: Placental and fetal effects of antenatal exposure to antidepressants or untreated maternal depression.
abstract: OBJECTIVE
  To assess systematically the effects of antidepressants and untreated maternal depression on human placenta and the developing fetus.
  
  
  METHODS
  Pertinent medical literature information was identified using MEDLINE/PubMed, SCOPUS and EMBASE. Electronic searches, limited to human studies published in English, provided 21 studies reporting primary data on placental and fetal effects of antidepressant exposure or untreated gestational depression.
  
  
  RESULTS
  The impact of antidepressants and non-medicated maternal depression on placental functioning and fetal biochemical architecture seems to be demonstrated, although its clinical significance remains unclear. More robust data seem to indicate that exposure to either antidepressants or untreated maternal depression may induce epigenetic changes and interfere with the physiological fetal behavior. Two cases of iatrogenic fetal tachyarrhythmia have also been reported.
  
  
  CONCLUSIONS
  Future research should clarify the clinical relevance of the impact of antidepressant and untreated maternal depression exposure on placental functioning. Moreover, ultrasound studies investigating fetal responses to antidepressants or maternal depressive symptoms are mandatory. This assessment should be performed during the whole duration of gestational period, when different fetal behavioral patterns become progressively detectable. Analyses of biochemical and epigenetic modifications associated with maternal mood symptoms and antidepressant treatment should also be implemented.
authors.affiliation: a ASL Salerno, Department of Mental Health, Mental Health Center Cava de' Tirreni, Vietri sul Mare , Salerno , Italy.|b Department of Neurosciences , Division of Perinatal Psychiatry, Medical School "Federico II", University of Naples , Naples , Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Gentile
authors.affiliation: c Mental Health Institute, Torre Annunziata , Naples , Italy , and.|d Department of Developmental Psychology , Post-Graduate School of Psychotherapy (SIPGI), Torre Annunziata, Naples , Italy.
authors.forename: Maria Luigia
authors.initials: ML
authors.lastname: Fusco
mesh_terms: D000928:Antidepressive Agents / Q000009:adverse effects* / Q000494:pharmacology; D003866:Depressive Disorder / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005333:Fetus / Q000187:drug effects*; D006801:Humans; D010920:Placenta / Q000187:drug effects*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000503:physiopathology*; D016216:Ultrasonography, Prenatal
chemical_list: D000928:Antidepressive Agents
keywords: Antidepressants; epigenetic changes; fetal effects; maternal depression; placental alterations; pregnancy; safety