SerpApi.Org
Common medications used during pregnancy may disrupt a key process involved in fetal brain development, a new review suggests.
In the review, published in the Journal of Clinical Investigation, researchers from the University of Nebraska Medical Center examined evidence linking a range of medications—including some antipsychotics, antidepressants, beta blockers and cholesterol-lowering drugs—to disruptions in cholesterol production in the developing brain.
While cholesterol is often discussed in the context of heart disease, scientists say it plays a vital role in fetal brain development.
The brain contains around a quarter of the body’s cholesterol, and during pregnancy it relies heavily on its own cholesterol production to support processes such as nerve growth, synapse formation and myelination—the development of the protective coating around nerve fibers.
However, experts caution that the findings do not mean these medications have been shown to cause developmental problems in children.
“The evidence in people is not yet strong enough to conclude that these biological changes lead to differences in children’s neurodevelopment,” Dr. Jennifer Choi, a maternal-fetal medicine specialist at Stony Brook Medicine in New York, told Newsweek.
Choi said laboratory and animal research has shown that some medications can interfere with cholesterol production and trigger changes linked to abnormal brain development. But whether those findings translate to humans remains unclear.
“This research identifies an important biological pathway that deserves further study, but it should not be interpreted as evidence that these medications cause neurodevelopmental disorders in children,” she said.
The review highlights concerns about a group of drugs known as sterol biosynthesis-inhibiting medications (SBIMs), which can unintentionally interfere with the body’s ability to produce cholesterol.
According to the researchers, the problem is not limited to lowered cholesterol levels. When cholesterol production is disrupted, a precursor molecule called 7-dehydrocholesterol (7-DHC) can accumulate.
This compound is highly vulnerable to oxidation and can form toxic byproducts known as oxysterols, which may damage developing brain tissue.
“Given the intense demand for cholesterol synthesis in the developing brain, prenatal exposure to sterol biosynthesis-inhibiting medications may have far-reaching effects,” the authors wrote.
The concern stems partly from what scientists have learned from rare genetic disorders. Conditions such as Smith-Lemli-Opitz syndrome and desmosterolosis are caused by mutations in genes involved in cholesterol production and can result in severe neurodevelopmental problems, including intellectual disability, behavioral difficulties and structural brain abnormalities.
Researchers say some medications may mimic aspects of these disorders by disrupting the same biological pathways.
For pregnant women currently taking medications, Choi stressed that the review should not be viewed as a reason to stop treatment.
“Medication decisions during pregnancy should always balance the well-established risks of untreated maternal illness against the potential, and in many cases still uncertain, risks of fetal medication exposure,” she said.
She noted that untreated medical and mental health conditions can themselves increase the risk of complications, including preterm birth, fetal growth restriction and low birth weight.
“For many patients with moderate to severe depression or anxiety, continuing effective treatment during pregnancy is supported because the benefits of maintaining maternal health often outweigh the potential risks of medication exposure,” Choi said.
Instead, she encouraged women who are pregnant or planning a pregnancy to discuss medications with their healthcare providers, ideally before conception, so treatment plans can be reviewed and adjusted if necessary.
Reference
Peeples, E.S., Korade, Z. and Mirnics, K. (2026). Sterol biosynthesis, brain development, and disease. Journal of Clinical Investigation, [online] 136(14). doi:10.1172/jci208000.
Contact Newsweek editors on this story: Kara Dolman and Emma Lee-Sang
Related Articles
