Antidepressant use in pregnancy and persistent pulmonary hypertension of the newborn (PPHN): a systematic review

Reprod Toxicol. 2012 Nov;34(3):293-7. doi: 10.1016/j.reprotox.2012.04.015. Epub 2012 May 5.

Abstract

Background: An association between PPHN and antidepressant use in pregnancy has been reported.

Purpose: We sought to examine this relationship.

Methods: A review of the literature was performed, to evaluate this association.

Results: Six published studies fulfilled our criteria for inclusion, with only three studies large enough to have the power to detect an association. There appears to be a small but significantly, increased risk of late pregnancy SSRI exposure associated with PPHN in one case-control study; OR 5.1 (95% CI, 1.9-13.3) and two large cohort studies; RR 2.56; (95% CI, 1.17-4.85) and OR 2.1 (95% CI, 1.5-3.0) The other three studies did not find an association.

Conclusion: the absolute risk cannot be determined, but it is very small, probably less than 1%. If a pregnant woman requires pharmacological treatment, this information does not support discontinuation or lowering the dose of the antidepressant.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Antidepressive Agents / adverse effects*
  • Female
  • Humans
  • Infant, Newborn
  • Persistent Fetal Circulation Syndrome / chemically induced*
  • Pregnancy
  • Serotonin Uptake Inhibitors / adverse effects*

Substances

  • Antidepressive Agents
  • Serotonin Uptake Inhibitors