SSRI Use in Late Pregnancy Linked to Pulmonary Hypertension in Newborns

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ssri-antidepressants-newborn-pulmonary-hypertensionRecently published research reports that use of SSRI antidepressants late in pregnancy is linked to increased risk for persistent pulmonary hypertension (PPH) in newborns.

Lead author, Dr. Sophie Grigoriadis, and colleagues conducted a meta-analysis of seven studies, which showed a significant association between PPH – increased pressure in the pulmonary arteries – in infants whose mothers used selective serotonin reuptake inhibitors (SSRIs) during the last trimester of pregnancy, Medscape Medical News reports.

Dr. Grigoriadis, head of the women’s mood and anxiety clinic at Sunnybrook Health Sciences Center in Toronto, Canada, and associate professor of psychiatry at the University of Toronto said the researchers wanted to look at “the risk difference,” which was 3 per 1000 infants. According to Medscape Medical News, this study did not show an association between newborn PPH and SSRI exposure during early pregnancy.

The researchers stressed the importance of weighing the mother’s health as well as that of the fetus in treatment decisions, considering both the risks of exposing the fetus to SSRI antidepressant drugs and the risk of severe depressive illness in the mother. The study was published online on January 14, 2014 in the British Medical Journal (BMJ).

Symptoms of PPH in newborns include respiratory distress and hypoxia (insufficient oxygen). PPH occurs in about 1.9 per 1000 live births.  In 2006, both the U.S. Food and Drug Administration (FDA) and Health Canada issued advisories about the possible link between maternal SSRI use and PPH in newborns. In 2011, the FDA said it was too early to reach a conclusion about the link. Dr. Grigoriadis’ research team has been engaged in a research program to understand the risks of various treatments and “develop a reference guide to help clinicians and their patients make more informed treatment decisions,” according to Medscape Medical News.

For this meta-analysis, the researchers examined seven English-language studies that met their inclusion criteria. All infants were at least 33 to 34 weeks gestation and no preterm births were included. The analysis showed a significantly increased risk for PPH in newborns exposed to SSRIs in late pregnancy (odds ratio [OR], 2.50; 95% confidence interval  [CI], 1. 32 – 4.73;  P = .005) but not for those exposed during early pregnancy (OR, 1.23).