Preclinical and Translational Studies

**67**

infants of depressed mothers [7].

**Chapter 4**

**Abstract**

**1. Introduction**

Influences of Maternal

the Developing Offspring

*Laura Staal and Jocelien DA Olivier*

health of the developing child across the life span.

inhibitors, antidepressants, pregnancy, neurodevelopment

Vulnerability and Antidepressant

Maternal vulnerability to adversity has long-term impact on the developing child. About 20% of the pregnant women suffer from affective disorders. Fetal exposure to maternal adversity may lead to detrimental consequences later in life. Maternal affective disorders are increasingly treated with antidepressants, especially selective serotonin reuptake inhibitors (SSRIs). However, the long-term consequences for the offspring after exposure to this medication are unclear. The interplay between maternal adversity and SSRI treatment has been under investigation and here we discuss how maternal adversity and SSRIs are able to shape offspring development. Specifically, we will discuss animal models addressing behavioral outcomes to understand how the prenatal environment influences the

**Keywords:** maternal vulnerability, maternal depression, selective serotonin reuptake

Although pregnancy is often portrayed as a time of great joy, that is not the reality for all women. Depressive symptoms during pregnancy are not uncommon; in fact, 20% of women experience some depressive symptoms during any time of their pregnancy [1]. The number of women who suffer from major depression during pregnancy is estimated to be 4–8% [2, 3]. According to the DSM-5, this disorder is characterized by a depressed mood or loss of interest or pleasure in daily activities for more than 2 weeks. Depression is accompanied by impaired social, occupational, and educational functioning. Untreated antenatal depression, that is to say a depressive episode during pregnancy, may have a tremendous effect on the developing child [4]. Maternal vulnerabilities during pregnancy, such as depression, anxiety, or high

stress levels due to other reasons, are associated with increased and continued activation of the hypothalamic-pituitary-adrenal (HPA) axis. The continued activation of the HPA axis in depressed patients causes an elevated stress response and increased cortisol levels [5]. About 40% of the cortisol passes through the placenta [6]. Consequently, increased cortisol levels are found in the urine and saliva of the

Treatment during Pregnancy on

#### **Chapter 4**
