Significance of 5HT receptor during pregnancy

Abstract

Serotonin (5-hydroxytryptamine; 5-HT) is a multifunctional neurotransmitter that plays a crucial role in regulating physiological processes beyond the central nervous system, including reproduction and pregnancy. The diverse actions of serotonin are mediated through a family of 5-HT receptors, comprising multiple subtypes with distinct tissue distributions and signaling mechanisms. During pregnancy, 5-HT receptors are expressed in maternal, placental, and fetal tissues, where they contribute to critical processes such as implantation, placental development, uteroplacental blood flow regulation, immune modulation, and fetal organogenesis. Emerging evidence suggests that alterations in serotonergic signaling can influence pregnancy outcomes by affecting trophoblast invasion, vascular adaptation, and endocrine function. Specific receptor subtypes, including 5-HT1, 5-HT2, 5-HT4, and 5-HT7 receptors, have been implicated in maintaining uterine quiescence, regulating vascular tone, and supporting fetal neurodevelopment. Dysregulation of 5-HT receptor activity has been associated with pregnancy-related complications such as preeclampsia, intrauterine growth restriction, preterm birth, and gestational hypertension. Furthermore, the widespread use of selective serotonin reuptake inhibitors (SSRIs) during pregnancy has intensified interest in understanding receptor-mediated effects on both maternal health and fetal development. This review summarizes current knowledge regarding the expression, distribution, and functional significance of 5-HT receptor subtypes during pregnancy. It highlights the molecular mechanisms through which serotonergic pathways influence maternal-fetal physiology and discusses their potential involvement in pregnancy disorders. A comprehensive understanding of 5-HT receptor signaling may facilitate the identification of novel therapeutic targets and improve strategies for managing pregnancy-related complications while ensuring maternal and fetal well-being.

Keywords