Department of Women's and Children's Health, Uppsala University Uppsala, Sweden ; Center for Gender Medicine, Karolinska Institutet Stockholm, Sweden.
Front Cell Neurosci. 2013 May 21;7:73. doi: 10.3389/fncel.2013.00073. eCollection 2013.
It has been estimated that 20% of pregnant women suffer from depression and it is well-documented that maternal depression can have long-lasting effects on the child. Currently, common treatment for maternal depression has been the selective serotonin reuptake inhibitor medications (SSRIs) which are used by 2-3% of pregnant women in the Nordic countries and by up to 10% of pregnant women in the United States. Antidepressants cross the placenta and are transferred to the fetus, thus, the question arises as to whether children of women taking antidepressants are at risk for altered neurodevelopmental outcomes and, if so, whether the risks are due to SSRI medication exposure or to the underlying maternal depression. This review considers the effects of maternal depression and SSRI exposure on offspring development in both clinical and preclinical populations. As it is impossible in humans to study the effects of SSRIs without taking into account the possible underlying effects of maternal depression (healthy pregnant women do not take SSRIs), animal models are of great value. For example, rodents can be used to determine the effects of maternal depression and/or perinatal SSRI exposure on offspring outcomes. Unraveling the joint (or separate) effects of maternal depression and SSRI exposure will provide more insights into the risks or benefits of SSRI exposure during gestation and will help women make informed decisions about using SSRIs during pregnancy.
据估计,20%的孕妇患有抑郁症,而且有大量文献记载表明,产妇抑郁症会对孩子产生持久的影响。目前,针对产妇抑郁症的常见治疗方法是选择性 5-羟色胺再摄取抑制剂(SSRIs)药物治疗,北欧国家有 2-3%的孕妇会采用这种方法,而美国则有高达 10%的孕妇会采用。抗抑郁药会穿过胎盘并转移到胎儿身上,因此,人们开始质疑服用抗抑郁药的女性的孩子是否存在神经发育异常的风险,如果存在,那么这种风险是由于 SSRI 药物暴露还是由于潜在的产妇抑郁症引起的。这篇综述考虑了产妇抑郁症和 SSRI 暴露对临床和临床前人群后代发育的影响。由于在不考虑潜在的产妇抑郁症(健康孕妇不会服用 SSRI)的情况下,不可能在人类中研究 SSRI 的影响,因此动物模型具有巨大的价值。例如,可以使用啮齿动物来确定产妇抑郁症和/或围产期 SSRI 暴露对后代结局的影响。阐明产妇抑郁症和 SSRI 暴露的共同(或单独)作用将更深入地了解妊娠期间 SSRI 暴露的风险或益处,并帮助女性在怀孕期间做出有关使用 SSRI 的明智决策。