Maternal and Fetal Factors That Influence Prenatal Exposure to Selective Serotonin Reuptake Inhibitor Antidepressants

Prenatal serotonin reuptake inhibitor (SRI) exposure is common and neonatal outcomes vary greatly, often leading to confusion about whether to use or even continue antenatal use of these antidepressants. Importantly, some but not all infants are affected, which raises questions about how maternal drug metabolism contributes to fetal drug exposure. To address this question, this chapter reviews the role of key maternal, fetal, and placental pharmacokinetic, metabolic, and genetic factors that affect the extent of fetal drug exposure. Considering the role of these factors may further our understanding of variables that might assist in optimizing maternal psychopharmacotherapy during pregnancy and neonatal outcomes.