Effect of exposure to selective serotonin reuptake inhibitors. In Utero on fetal growth: Potential role for the IGF-I and HPA axes

  • Davidson S
  • Prokonov D
  • Taler M
 et al. 
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Abstract

To investigate the possible effect of fetal exposure to selective serotonin reuptake inhibitors (SSRIs) on somatic growth and on hormones of the hypothalamic-pituitary-adrenal (HPA) and insulin-like growth factor (IGF)-I axes, we compared the anthropo- metric parameters and hormonal profile of 21 SSRI-exposed infants and 20 matched controls. The SSRI group was characterized by lower crown-heel length (p ? 0.01), smaller head circumference (p ? 0.08), and higher percentage of infants with birth weight, birth length, and head circumference below the 10th percentile (p?0.045, p ? 0.08, p ? 0.04, respectively), in addition to a significantly lower cord blood level of cortisol (p ? 0.03) and higher level of thyroid- stimulating hormone (TSH) (p ? 0.004). Infants exposed to citalo- pram had a lower cord blood IGF-I level than infants exposed to paroxetine (p ? 0.001) and controls (p ? 0.003). Placental IGF-I receptor (IGF-IR) expression was significantly higher in the SSRI group than in controls (p ? 0.01). Urine 5-hydroxyindoleacetic acid (5-HIAA) level was negatively correlated with birth weight (r ? ?0.71, p ? 0.025) and with dehydroepiandrosterone (DHEA) level (r ??0.71, p ? 0.025). The Finnegan score was correlated with dehydroepiandrosterone sulfate (DHEAS) (r ? 0.8, p ? 0.005) and cortisol (r ? 0.62, p ? 0.05). Fetal exposure to SSRIs causes impaired intrauterine growth accompanied by alterations in the IGF-I and HPA axes. The findings may raise concern regarding maternal use of SSRIs during pregnancy. (Pediatr

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Authors

  • Shmuel Davidson

  • Diana Prokonov

  • Michal Taler

  • Rachel Maayan

  • Daniella Harell

  • Irit Gil-Ad

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