Maternal Antidepressant Use May Raise Risk Of New-Born Persistent Pulmonary Hypertension

Antidepressant Medication – Greater Risk of PPHN

Mothers of new-born who tend to use antidepressant medication at the later stage of their pregnancy could be at greater risk of persistent pulmonary hypertension as per a new study published by The Journal of the American Medical Association –JAMA. Neonatal pulmonary or persistent pulmonary hypertension in new-born – PPHN, takes place when the baby’s blood circulation does not permit them to breath properly outside the womb.

In the case of PPHN, the baby tends to experience high blood pressure in the arteries which travel to the lungs and restricts the amount of blood from flowing to them which reduces the amount of oxygen in the bloodstream.

It could also be life threatening condition and it is estimated that about 10 – 20% of infants suffering from this condition do not survive and those who tend to survive, suffer from severe lifelong illnesses like neurodevelopmental disorders and chronic lung disease. The US Food and Drug Administration – FDA had issued a public health advisory in 2006 for using the antidepressants selective serotonin reuptake inhibitors – SSRIs at the later stage of pregnancy, when a study had indicated that the use tends to increase the risk of PPHN.

SSRI & PPHN in Late Pregnancy – Conflicting Findings

Nevertheless, the FDA had updated the public health advisory on the use of SSRI in later pregnancy indicating that health care profession should not change their present treatment strategies for depression at the time of pregnancy since further research assessing the link between SSRI use in late pregnancy and PPHN tend to produce `conflicting findings’. Besides Krista F. Huybrechts of Brigham and Women’s Hospital in Boston, MA, and the researchers of the latest study, together with the previous research, found that no increased risk of PPHN and SSRI use in late pregnancy were small and they could have insufficient power to detect an increased risk.

Huybrechts together with her colleagues set about to assess the use between the link of SSRIs and non-SSRI antidepressants as well as the risk of PPHN with a sample of 3,789,330 pregnant women from 46 US state and Washington DC. The women were enrolled in the 2000-10 Medicaid Analytic eXtract – MAX and SSRI together with non SSRI use among the pregnant women for 90 days before they gave birth up to delivery was assessed.

Small Increased Risk of PPHN with Antidepressants, Late Pregnancy

PPHN incident in the new-borns was assessed in the 30 days after their delivery. The team recognized antidepressant use in 3.4% of the women in the last 90 days of pregnancy with 2.7% of them using SSRIs and 0.7% using non SSRIs.

When compared to those who did not use antidepressant in the later stage of their pregnancy, those who used antidepressant would probably have new-borns with PPHN and is slightly higher among infants exposed to SSRIs at 31.5 per 10,000 when compared with 29.1 per 10,000 among infants that are exposed to non-SSRIs.

Researchers also observed the risk of PPHN with SSRI as well as non-SSRI use, tend to reduce when possible confounding factors were taken into account. According to the team, their discoveries highlight a small increased risk of PPHN using antidepressants in late pregnancy especially SSRIs. They noticed that the identified risk increase is more modest than what was reported in the earlier research.