Research — 17 January 2014

Infants born to mothers who were taking SSRIs in late pregnancy are at increased risk of persistent pulmonary hypertension, Canadian research shows.

Fetuses exposed to SSRIs at 33 weeks’ gestation or later were two and a half times more likely to develop persistent pulmonary hypertension compared with newborns with no exposure, a systematic review and meta-analysis found.

The findings echo those of a large Scandavian study from 2012, as reported by Australian Doctor.bigstock-Child-Portrait-5332592

Exposure in early pregnancy did not affect newborns’ risk of developing the condition, the latest study found.

The absolute risk was still low, researchers wrote in the BMJ, noting that persistent pulmonary hypertension affects only two in every 1000 births overall.

“We estimated that we would have to treat 286-351 women with an SSRI in late gestation to see one additional case of persistent pulmonary hypertension in newborns,” wrote Associate Professor Sophia Grigoriadis, of the University of Toronto’s Department of Psychiatry, and colleagues.

This risk should be weighed against the potentially serious effects of leaving depression untreated during pregnancy, they said.

“[Patients] must be counselled on both the risks of exposing the fetus to antidepressant drugs and the risks of severe depressive illness … depression during pregnancy must not be left untreated,” the authors said.

Pregnant women could also be reassured that persistent pulmonary hypertension in newborns, although serious, can typically be managed successfully, they added.

The meta-analysis involved seven studies assessing rates of persistent pulmonary hypertension with antidepressant use during pregnancy.

Only SSRIs were included, due to a lack of data for other classes of antidepressants.

This article first appeared on Australian Doctor on 15 January, 2014.


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