From the OptumLabs Data Warehouse, researchers identified 226,932 singleton deliveries. Cases of antidepressant exposure were defined as pregnancies with prescription claims for antidepressants submitted between the last menstrual period and 35 weeks’ gestation. To [...]
A few days ago, an article was published in the journal Pediatrics on neonatal morbidity observed in children exposed to antidepressants. Although this article is likely to find its way into the headlines, it is [...]
In 2006, Chambers and colleagues published an article linking selective serotonin reuptake inhibitor (SSRI) antidepressant use during late pregnancy to an increased risk of persistent pulmonary hypertension in the newborn (PPHN). PPHN is a cardiovascular [...]
You can find a more recent post on this topic here: Venlafaxine and Duloxetine: Pooled Analysis Shows No Increase in Risk of Malformations We receive a fair number of questions on the use of duloxetine [...]
The PPHN story has been a bit of a rollercoaster. Just to review…
In 2006, Chambers and colleagues published an article linking SSRI use during late pregnancy to an increased risk of persistent pulmonary hypertension in the newborn (PPHN). Since that time, several other reports have been published which have examined the association between SSRI antidepressants and PPHN. Here is a summary of the findings to date:
In 2006, Chambers and colleagues published an article linking SSRI use during late pregnancy to an increased risk of persistent pulmonary hypertension in the newborn (PPHN). Based on the results of this analysis, the authors estimated the risk of PPHN to be about 1% in infants exposed to SSRIs late in pregnancy (after 20 weeks). However, subsequent studies did not demonstrate a significant association between PPHN and SSRI usage. A new study, this one relying upon data from the Swedish Medical Birth Register, has observed an elevated risk of PPHN among SSRI-exposed infants.
Over the past few years, multiple reports have raised questions regarding the safety of selective serotonin reuptake inhibitor (SSRI) antidepressants during pregnancy. Chambers and colleagues reported that exposure to SSRIs late in pregnancy may be associated with an increased risk of persistent pulmonary hypertension of the newborn (PPHN). In the general population, PPHN affects about 1 to 2 per 1000 live births. Infants with PPHN are typically full-term or near-term and present shortly after delivery with severe respiratory distress. In the worst cases, PPHN requires intubation and mechanical ventilation and may result in long-term morbidity. In 2006, Chambers and colleagues published an article linking SSRI use during late pregnancy to an increased risk of persistent pulmonary hypertension in the newborn. Based on the results of this analysis, the authors estimated the risk of PPHN to be about 1% in infants exposed to SSRIs late in pregnancy (after 20 weeks).
Literature accumulated over the last decade supports the use of certain selective serotonin reuptake inhibitors (SSRIs) and the older tricyclic antidepressants during pregnancy, indicating no increased risk of congenital malformation in children exposed to these medications during the first trimester of pregnancy. Still, questions remain regarding the purported risk for "toxicity" in newborns exposed to antidepressants around the time of labor and delivery (see Fall 2004 and Spring 2005 Newsletters). In addition, a recent study published in the New England Journal of Medicine has linked SSRI use during late pregnancy to an increased risk of persistent pulmonary hypertension in the newborn (Chambers 2006).
