A Tripartite Framework of Conflict-Induced Stress, Acoustic Hypervigilance, and Ramadan Observance as Convergent Determinants of Circadian Decoherence in Athletes.

Depression and anxiety affect an alarming 1 in 10 pregnancies, and selective serotonin reuptake inhibitors (SSRIs) are the most prescribed pharmaceuticals during pregnancy []. Untreated perinatal depression is associated with adverse maternal and child outcomes such as lack of self‐care, premature birth, and impaired maternal functioning. Thereby, clinicians must balance the benefits of treatment against potential fetal risks [, ]. At the same time, medication use in pregnancy raises concerns about neurodevelopment, particularly cognition, language, and motor skills in childhood. Serotonin, specifically 5‐hydroxytryptamine (5‐HT), is central to mood regulation and also plays key roles in fetal brain development such as neuronal proliferation/migration, synaptogenesis, and cortical circuit formation, as well as broader processes (e.g., sleep, attention, memory, and stress responsivity via the HPA axis) []. SSRIs are widely known to cross the placenta and fetal blood–brain barrier, thus increasing extracellular 5‐HT and potentially altering serotonergic signaling during sensitive developmental windows, which may influence later cognitive and behavioral outcomes [, ]. Recent observational studies and a few randomized analyses have examined children exposed in utero to SSRIs. Their findings are mixed; some report small deficits in general cognitive or language scores, whereas others find no difference compared with unexposed peers. Interpretation is complicated by confounding by indication, comedications, timing or dose of exposure, prematurity, and other socioeconomic factors. [] Heterogeneity in outcome instruments (e.g., Bayley Scales of Infant Development, McCarthy General Cognitive Index, WPPSI, and NEPSY) and assessment ages further limits comparability.