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Hypothalamic-pituitary-adrenal (HPA) axis function in 3-month old infants with prenatal selective serotonin reuptake inhibitor (SSRI) antidepressant exposure.
Early Hum Dev. 2008 Oct; 84(10):689-97.EH

Abstract

BACKGROUND

Prenatal exposure to stress and selective serotonin reuptake inhibitors (SSRIs) alter hypothalamic-pituitary-adrenal (HPA) stress reactivity in offspring, however, the effects of combined exposure to HPA activity in human infants is unknown.

OBJECTIVE

To examine HPA basal levels and stress responsiveness in 3-month olds with prenatal exposure to SSRIs.

METHODS

Salivary cortisol levels in infants of SSRI treated mothers (n=31, mean exposure 230.2+/-72.2 days) were compared with non-SSRI exposed (n=45) infants in response to a challenge (infant-controlled habituation task) and under basal conditions in the late afternoon/early evening. Mode of feeding, to account for possible postnatal drug exposure via breast milk, as well as measures of pre and postnatal maternal mood, were included as covariates.

RESULTS

Lower post-stress cortisol levels were observed in non-SSRI exposed/non-breastfed infants compared with non-SSRI exposed infants who were breastfed at 3 months of age. Stress reactivity patterns among SSRI exposed infants did not differ with mode of feeding. The cortisol reactivity slope (CRS) was significantly lower among non-SSRI exposed non-breastfed infants compared with non-SSRI exposed breastfed infants. Early evening basal cortisol levels were lower in SSRI exposed infants than in non-SSRI exposed infants, controlling for maternal mood and mode of feeding. Postnatal SSRI exposure (infant SSRI drug levels) via breast milk was not associated with stress or basal cortisol levels. Total cortisol, reflected by the AUC measure, did not differ significantly between exposure groups.

CONCLUSIONS

Prenatal SSRI exposure altered HPA stress response patterns and reduced early evening basal cortisol levels. Stress challenge HPA response differences only became apparent when the moderating effect of method of feeding was accounted for. These findings suggest an early "programming" effect of antenatal maternal mood, prenatal SSRI exposure and postnatal maternal care giving on the HPA system.

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Authors+Show Affiliations

Oberlander TF
Department of Pediatrics, UBC, Vancouver, BC, Canada V6H 3V4. toberlander@cw.bc.ca
Grunau R
No affiliation info available
Mayes L
No affiliation info available
Riggs W
No affiliation info available
Rurak D
No affiliation info available
Papsdorf M
No affiliation info available
Misri S
No affiliation info available
Weinberg J
No affiliation info available

MeSH

AdultAffectAntidepressive AgentsDepressionFemaleFollow-Up StudiesHumansHydrocortisoneHypothalamo-Hypophyseal SystemInfantPituitary-Adrenal SystemPregnancyPregnancy ComplicationsPrenatal Exposure Delayed EffectsSalivaSerotonin Uptake InhibitorsStress, Psychological

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

18639992

Citation

Oberlander, Tim F., et al. "Hypothalamic-pituitary-adrenal (HPA) Axis Function in 3-month Old Infants With Prenatal Selective Serotonin Reuptake Inhibitor (SSRI) Antidepressant Exposure." Early Human Development, vol. 84, no. 10, 2008, pp. 689-97.
Oberlander TF, Grunau R, Mayes L, et al. Hypothalamic-pituitary-adrenal (HPA) axis function in 3-month old infants with prenatal selective serotonin reuptake inhibitor (SSRI) antidepressant exposure. Early Hum Dev. 2008;84(10):689-97.
Oberlander, T. F., Grunau, R., Mayes, L., Riggs, W., Rurak, D., Papsdorf, M., Misri, S., & Weinberg, J. (2008). Hypothalamic-pituitary-adrenal (HPA) axis function in 3-month old infants with prenatal selective serotonin reuptake inhibitor (SSRI) antidepressant exposure. Early Human Development, 84(10), 689-97. https://doi.org/10.1016/j.earlhumdev.2008.06.008
Oberlander TF, et al. Hypothalamic-pituitary-adrenal (HPA) Axis Function in 3-month Old Infants With Prenatal Selective Serotonin Reuptake Inhibitor (SSRI) Antidepressant Exposure. Early Hum Dev. 2008;84(10):689-97. PubMed PMID: 18639992.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hypothalamic-pituitary-adrenal (HPA) axis function in 3-month old infants with prenatal selective serotonin reuptake inhibitor (SSRI) antidepressant exposure. AU - Oberlander,Tim F, AU - Grunau,Ruth, AU - Mayes,Linda, AU - Riggs,Wayne, AU - Rurak,Dan, AU - Papsdorf,Michael, AU - Misri,Shaila, AU - Weinberg,Joanne, Y1 - 2008/07/18/ PY - 2008/04/08/received PY - 2008/06/06/revised PY - 2008/06/06/accepted PY - 2008/7/22/pubmed PY - 2009/1/8/medline PY - 2008/7/22/entrez SP - 689 EP - 97 JF - Early human development JO - Early Hum Dev VL - 84 IS - 10 N2 - BACKGROUND: Prenatal exposure to stress and selective serotonin reuptake inhibitors (SSRIs) alter hypothalamic-pituitary-adrenal (HPA) stress reactivity in offspring, however, the effects of combined exposure to HPA activity in human infants is unknown. OBJECTIVE: To examine HPA basal levels and stress responsiveness in 3-month olds with prenatal exposure to SSRIs. METHODS: Salivary cortisol levels in infants of SSRI treated mothers (n=31, mean exposure 230.2+/-72.2 days) were compared with non-SSRI exposed (n=45) infants in response to a challenge (infant-controlled habituation task) and under basal conditions in the late afternoon/early evening. Mode of feeding, to account for possible postnatal drug exposure via breast milk, as well as measures of pre and postnatal maternal mood, were included as covariates. RESULTS: Lower post-stress cortisol levels were observed in non-SSRI exposed/non-breastfed infants compared with non-SSRI exposed infants who were breastfed at 3 months of age. Stress reactivity patterns among SSRI exposed infants did not differ with mode of feeding. The cortisol reactivity slope (CRS) was significantly lower among non-SSRI exposed non-breastfed infants compared with non-SSRI exposed breastfed infants. Early evening basal cortisol levels were lower in SSRI exposed infants than in non-SSRI exposed infants, controlling for maternal mood and mode of feeding. Postnatal SSRI exposure (infant SSRI drug levels) via breast milk was not associated with stress or basal cortisol levels. Total cortisol, reflected by the AUC measure, did not differ significantly between exposure groups. CONCLUSIONS: Prenatal SSRI exposure altered HPA stress response patterns and reduced early evening basal cortisol levels. Stress challenge HPA response differences only became apparent when the moderating effect of method of feeding was accounted for. These findings suggest an early "programming" effect of antenatal maternal mood, prenatal SSRI exposure and postnatal maternal care giving on the HPA system. SN - 0378-3782 UR - https://www.unboundmedicine.com/medline/citation/18639992/Hypothalamic_pituitary_adrenal__HPA__axis_function_in_3_month_old_infants_with_prenatal_selective_serotonin_reuptake_inhibitor__SSRI__antidepressant_exposure_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0378-3782(08)00120-5 DB - PRIME DP - Unbound Medicine ER -