Amniotic fluid and umbilical cord blood concentrations of antidepressants in three women

Background: Pregnancy and the postpartum period are a time of increased ris k for women to develop mood disorders. As such, the reproductive safety dat a on antidepressant use during pregnancy have rapidly expanded over the las t decade; however, there is relatively sparse information on maternal/fetal exchange of these medications and no data reporting their concentrations i n amniotic fluid. Methods: We report on three women treated during pregnancy with fluvoxamine , sertraline, and venlafaxine, respectively. Amniotic fluid at amniocentesi s and umbilical cord blood and maternal blood at delivery were collected an d analyzed for antidepressant concentrations using high performance liquid chromatography with UV detection. Results: Antidepressant and metabolite concentrations were detectable in al l amniotic fluid samples, though parent compound concentrations were less t han maternal serum and umbilical cord blood concentrations. No adverse effe cts of the medication were reported Conclusions: The presence of these antidepressants in amniotic fluid sugges ts that fetal exposure to these medications is continual and may occur thro ugh a variety of paths, thus accounting for increased fetal exposure. These paths include circulatory via placental passage, gastrointestinal via feta l swallowing, and respiratory secondary to fetal lung absorption, (C) 2000 Society of Biological Psychiatry.