Expectant mothers on SSRIs risk newborns with high blood pressure in the lungs
Mothers who take SSRI anti-depressants during pregnancy are more likely to give birth to children with high blood pressure in the lungs, so called persistent pulmonary hypertension. This according to a study lead by researchers at Karolinska Institutet, and now published in the British Medical Journal (BMJ).
The study's authors acknowledge that the figures are small and that the risks of persistent pulmonary hypertension was as low as three infants per 1000 exposed with similar risks between the assessed drugs, but if an anti-depressant was taken in late pregnancy the risk seems to be more than doubled in comparison with non-exposed cases. In conclusion, caution was advised when treating pregnant women with SSRIs.
Persistent pulmonary hypertension is a condition with high blood pressure in the lungs leading to difficulties in breathing. It is a rare, but severe disease with strong links to heart failure.
The study, carried out by researchers from the five Nordic countries at the Centre for Pharmacoepidemiology at Karolinska Institutet, looked at 1.6 million births in total between 1996 and 2007 in babies born after 231 days (33 weeks) in Denmark, Finland, Iceland, Norway and Sweden. A total of 1,618,255 singleton births were included in the study. Approximately 11,000 of the mothers filled out a prescription for anti-depressants in late pregnancy and approximately 17,000 in early pregnancy. A further 54,184 mothers were identified as having previously undergone psychiatric diagnosis but were not currently taking any medication. The uses of several drugs were analysed which included fluoxetine, citalopram, paroxetine, sertraline, fluvoxamine and escitalopram.
The study's results found that out of 11,014 mothers who used anti-depressants in late pregnancy just 33 babies (0.2%) were born with persistent pulmonary hypertension and out of 17,053 mothers who used anti-depressant drugs in early pregnancy, just 32 babies (less than 0.2%) were diagnosed with persistent pulmonary hypertension. A total of 114 babies whose mothers had previously been diagnosed with a mental illness were found to be suffering from the disease.
Publication
Selective serotonin reuptake inhibitors during pregnancy and risk of persistent pulmonary hypertension in the newborn: population based cohort study from the five Nordic countries.
BMJ 2012 Jan;344():d8012