Maternal Antidepressants Up Infant Pulmonary Hypertension

Similar risk found across the selective serotonin reuptake inhibitor class of antidepressants

FRIDAY, Jan. 13 (HealthDay News) -- Use of antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs), during pregnancy increases the risk of persistent pulmonary hypertension in newborns, according to a study published online Jan. 12 in BMJ.

To assess whether the use of SSRIs during pregnancy increased the risk of persistent pulmonary hypertension in newborns, Helle Kieler, M.D., Ph.D., of the Karolinska Institute in Stockholm, Sweden, and colleagues evaluated data from the national health registers of the five Nordic countries. Data from more than 1.6 million infants (born after gestational week 33) were included in the study.

The researchers found that 30,000 women had used SSRIs during pregnancy from 1996 to 2007, and that 11,014 had been prescribed an SSRI after gestational week 20. Exposure to SSRIs in late pregnancy was associated with an increased risk of persistent pulmonary hypertension in the newborn, with an absolute risk of three per 1,000 liveborn infants when compared with the background incidence of 1.2 per 1,000 (adjusted odds ratio [OR]; 2.1, 95 percent confidence interval [CI], 1.5 to 3.0). The increased risks for each of the specific SSRIs (sertraline, citalopram, paroxetine, and fluoxetine) were similar in magnitude. Filling a prescription for SSRIs before gestational week eight was associated with slightly increased risks (adjusted OR, 1.4; 95 percent CI, 1.0 to 2.0).

"The risk of persistent pulmonary hypertension of the newborn is low, but use of SSRIs in late pregnancy increases that risk more than two-fold. The increased risk seems to be a class effect," write the authors.

The study was funded by the Swedish Pharmacy Company.

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