Teratogenic Effects Caused By Prenatal Exposure to Selective Serotonin Reuptake Inhibitors
By: Nick Denney

There is a natural, almost unavoidable risk associated with pregnancy: virtually everything the mother does will have some sort of effect on the developing child. The prenatal environment is very sensitive, and highly susceptible to external influences. Anything that the mother takes in, be it beneficial or not, will have an impact on the overall health of the child once it enters the world. This parasitic nutritional process will help determine the beneficial or hindering mental and physical health effects of the baby early on and, potentially, throughout its life. The nutrients come from external sources, such as food, drink, and medication. Obviously, food and drink have a (typically) positive effect on the fetus; vitamins and minerals cross into the placenta, allowing the baby to benefit from these supporting blocks. However, an often-overlooked aspect of the prenatal environment is the usage of medication. Nearly 14% of women continue taking antidepressants such as Prozac and Paxil during pregnancy, despite an increasing number of studies linking these medications to birth defects and developmental delays (FDA, 2006). One of the more alarming correlations recently uncovered is the potential link between the use of selective serotonin reuptake inhibitors (SSRIs) and the increased risk of autism spectrum disorders. It is not a dramatic difference, but the fact there are measurable differences between the baseline risk and the increased risk is enough to encourage researchers to study this topic in depth. Be it in support of or against it, numerous studies have been done since the late 60’s, shortly after the thalidomide scare, to analyze the risk factors associated with virtually every drug used during pregnancy. Since antidepressants were not on the market until the 1950’s, the field of study involving this correlation is still relatively new, and there is no simple answer to whether there is a scientifically generalizable correlation between the two variables. However, the public is more than welcome to interpret the results of theses studies in whichever way they want. Researchers in favor of the pro-SSRI theory tend to create their own models, one of the major ones being the hyperserotonergic model; those who oppose the theory tend to derive their data from faults in studies or deliberately set out to disprove others. Regardless of stance, there are evident facts that cannot be avoided; these allow people to make an informed decision on whether to continue taking antidepressant medication during pregnancy and risk potential developmental problems, or find less-clinically supported, but almost on par in terms of effectiveness, ways of temporarily treating depression. The main goal of this research is to determine if there is any possible age effect associated with SSRI use during difference points in pregnancy, and what these abnormalities would entail. Depression is a very common condition in women, with its prevalence peaking during childbearing years. (Nulman et al, 1997). An estimated 8-20% of women will develop some symptoms of clinical depression at some point in their lives; 10-16% displays these symptoms during pregnancy, which are distinctly more common with the presence of a prior psychiatric diagnosis (Rahimi, Nikfar, & Abdollahi, 2006). SSRIs are among the most frequently prescribed antidepressant, yet there is so much we do not fully understand about it. Early studies (Chambers et al., 1996; Kulin, 1998) reported no increased risk in congenital deformations, but many of these were confounded by their small sample size and reliance on maternal recall. A major study aiming to expand on this hypothesis was done by Catherine Vasilakis-Scaramozza and her colleagues (of various departments of Boston University) in 2013. Ultimately, they found that SSRI use during pregnancy does not increase the risk for