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母亲使用抗抑郁药对后代行为和大脑发育的影响:对神经发育障碍风险的影响。

The effects of maternal antidepressant use on offspring behaviour and brain development: Implications for risk of neurodevelopmental disorders.

机构信息

School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales 2522, Australia; Illawarra Health and Medical Research Institute, Wollongong, New South Wales 2522, Australia.

出版信息

Neurosci Biobehav Rev. 2017 Sep;80:743-765. doi: 10.1016/j.neubiorev.2017.06.008. Epub 2017 Jun 16.

Abstract

Approximately 10% of pregnant women are prescribed antidepressant drugs (ADDs), with selective serotonin reuptake inhibitors (SSRIs) the most widely prescribed. SSRIs bind to the serotonin transporter (SERT), blocking the reabsorption of serotonin by the presynaptic neuron and increasing serotonin levels in the synaptic cleft. The serotonergic system regulates a range of brain development processes including neuronal proliferation, migration, differentiation and synaptogenesis. Given the presence of SERT in early brain development, coupled with the ability of SSRIs to cross the placenta and also enter breast milk, concerns have been raised regarding the effects of SSRI exposure on the developing foetus and newborns. In this review, we evaluate preclinical and clinical studies that have examined the effects of maternal SSRI exposure and the risk for altered neurodevelopment and associated behaviours in offspring. While the current body of evidence suggests that maternal SSRI treatment may cause perturbations to the neurobiology, behaviour and ultimately risk for neurodevelopmental disorders in exposed offspring, conflicting findings do exist and the evidence is not conclusive. However, given the increasing incidence of depression and number of women prescribed ADDs during pregnancy, further investigation into this area is warranted.

摘要

大约 10%的孕妇被开处抗抑郁药物(ADDs),其中选择性 5-羟色胺再摄取抑制剂(SSRIs)是最广泛开处的药物。SSRIs 与血清素转运体(SERT)结合,阻止突触前神经元对血清素的再摄取,增加突触间隙中的血清素水平。血清素能系统调节一系列大脑发育过程,包括神经元增殖、迁移、分化和突触形成。鉴于 SERT 存在于早期大脑发育中,再加上 SSRIs 能够穿过胎盘并进入母乳,人们对 SSRI 暴露对发育中的胎儿和新生儿的影响表示担忧。在这篇综述中,我们评估了检查母体 SSRI 暴露对后代神经发育改变和相关行为风险的临床前和临床研究。虽然目前的证据表明,母体 SSRI 治疗可能会导致神经生物学、行为和最终导致神经发育障碍的风险发生改变,但存在相互矛盾的发现,且证据尚不确定。然而,鉴于抑郁症的发病率不断上升,以及怀孕期间被处 ADDs 的女性人数不断增加,进一步研究这一领域是有必要的。

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