Peripartal treatment with high-dose sertraline increases the RankL/Opg ratio and leads to negative offspring outcomes

Abstract

Clinical depression is common during pregnancy and postpartum, impacting 16% of pregnant women and 20% of postpartum women . SSRIs are used to treat peripartal depression; however, little is known about long-term effects of these SSRIs on maternal bone health. We have shown that peripartal use of high-dose fluoxetine in rodents exacerbated normal calcium mobilization experienced during lactation, resulting in sustained reduction in maternal bone density. However, peripartal use of low-dose sertraline (10 mg/kg/d) in rodents did not impact maternal bone health. Therefore, we tested the hypothesis that high-dose sertraline (20 mg/kg/d) would alter maternal calcium signaling, similarly to high-dose fluoxetine. We observed an increase in the RankL/Opg ratio, as well as decreased litter size and offspring survival rate. This raises safety concerns for sertraline for the dam and her offspring when taken during the peripartal period.