Approximately one-fifth of women of childbearing age experience depressive symptoms. Many of them are prescribed selective serotonin reuptake inhibitors (SSRIs) as medical treatment. Various regulations come with drug usage to ensure the safety of both mother and fetus. The purpose of this study is to review the adverse effects of SSRIs on pregnant women and whether the use of this drug class can cause fetal cardiac abnormalities. 

Upon collecting data from Google Scholar and PubMed, the following literature data was compiled. The noted SSRI’s adverse effect were fetal cardiac abnormalities such as atrial septal defects and right ventricular outflow tract obstruction defects. A high prevalence of these cardiac defects was noted in women who use SSRIs such as paroxetine and fluoxetine. Paroxetine is hypothesized to cross the maternal placental barrier and enter the amniotic fluid. Another study also found that paroxetine specifically decreased the number of fetal heart cells, indicating that abnormal serotonin levels may alter fetal heart development. This literature review aims to focus on summarizing various SSRIs and how they contribute to cardiac fetal defects. The main goals will be to investigate underlying physiology, pharmacokinetics further and comparing SSRIs to see which are more effective and have minimal side effects. 

A better understanding of the underlying roles of the SSRIs mechanism of action in fetal cardiac development will aid in further studies generating better therapy for pregnant women with conditions such as anxiety and depression. Future studies can focus on why specific drugs lead to fetal cardiac defects and if such effects are manifested while using them during particular trimesters.