Sertraline use during pregnancy and effect on fetal cardiac function

Abstract

Objectives

The objective of this study was to evaluate the fetal cardiac function in human pregnancies exposed to sertraline (a selective serotonin reuptake inhibitor) compared to unexposed pregnancies.

Method

We included 44 women in gestational week 25 + 0 days to week 26 + 6 days. Fifteen women used sertraline (50–150 mg per day), and 29 women used no daily medication. We assessed fetal cardiac function by Myocardial Performance Index (MPI), E/A ratios and by tricuspid and mitral annular plane systolic excursion (TAPSE and MAPSE) measured by 2D M-mode and by 4D eSTIC M-mode.

Results

There were no differences between the sertraline exposed and the unexposed. The mean difference of MPI was 0.03 (95% CI −0.08–0.03), of tricuspid and mitral E/A ratios 0.00 (95% CI −0.03–0.05) and 0.03 (95% CI −0.07–0.01), respectively. The mean difference of TAPSE, by 2D and eSTIC, was 0.07 mm (95% CI −0.56–0.41) and 0.10 mm (95% CI −0.55–0.34). Mean difference of MAPSE, by 2D and eSTIC was 0.16 mm (95% CI −0.22–0.53) and 0.24 mm (95% CI −0.16–0.65), respectively. Serum levels of sertraline in exposed participants ranged from 33–266, median 92 nmol/L.

Conclusions

We found no significant differences in fetal cardiac function, assessed by TAPSE, MAPSE, MPI and E/A ratios, in pregnancies exposed to sertraline compared to the unexposed.

Keywords:

• Antidepressant
• fetal cardiac function
• pregnancy
• selective serotonin reuptake inhibitors

Acknowledgements

Recruitment from the Department of Obstetrics and Gynecology, Fetal Medicine Unit and the Mother-Baby Unit.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by University of Aarhus Denmark; Carl and Ellen Hertz’s scholarship; Ove William Buhl Olesen and Mrs. Edith Buhl Olesen Memorial Foundation; Professor Ann Tabor’s Foundation; Solar Foundation of 1978; Director Jacob Madsen and wife Olga Madsen’s Foundation.