Antenatal depression, treatment with selective serotonin reuptake inhibitors, and neonatal brain structure: A propensity-matched cohort study

Psychiatry Res Neuroimaging. 2016 Jul 30;253:43-53. doi: 10.1016/j.pscychresns.2016.05.004. Epub 2016 May 24.


The aim of this propensity-matched cohort study was to evaluate the impact of prenatal SSRI exposure and a history of maternal depression on neonatal brain volumes and white matter microstructure. SSRI-exposed neonates (n=27) were matched to children of mothers with no history of depression or SSRI use (n=54). Additionally, neonates of mothers with a history of depression, but no prenatal SSRI exposure (n=41), were matched to children of mothers with no history of depression or SSRI use (n=82). Structural magnetic resonance imaging and diffusion weighted imaging scans were acquired with a 3T Siemens Allegra scanner. Global tissue volumes were characterized using an automatic, atlas-moderated expectation maximization segmentation tool. Local differences in gray matter volumes were examined using deformation-based morphometry. Quantitative tractography was performed using an adaptation of the UNC-Utah NA-MIC DTI framework. SSRI-exposed neonates exhibited widespread changes in white matter microstructure compared to matched controls. Children exposed to a history of maternal depression but no SSRIs showed no significant differences in brain development compared to matched controls. No significant differences were found in global or regional tissue volumes. Additional research is needed to clarify whether SSRIs directly alter white matter development or whether this relationship is mediated by depressive symptoms during pregnancy.

Keywords: Antidepressant; Depression; Diffusion tensor imaging; Fetal development; Infant, Newborn; Magnetic resonance imaging.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Brain / diagnostic imaging*
  • Brain / drug effects
  • Cohort Studies
  • Depressive Disorder / drug therapy*
  • Diffusion Tensor Imaging
  • Female
  • Gray Matter / diagnostic imaging
  • Gray Matter / drug effects
  • Humans
  • Infant, Newborn
  • Male
  • Organ Size / drug effects
  • Pregnancy
  • Pregnancy Complications / drug therapy*
  • Prenatal Exposure Delayed Effects / diagnostic imaging*
  • Serotonin Uptake Inhibitors / pharmacology
  • Serotonin Uptake Inhibitors / therapeutic use*
  • Utah
  • White Matter / diagnostic imaging
  • White Matter / drug effects


  • Serotonin Uptake Inhibitors