Article

Maternal use of selective serotonin re-uptake inhibitors and persistent pulmonary hypertension of the newborn. Pharmacoepidemiol Drug Saf 17: 801-806

Pharmacoepidemiology and Drug Safety (Impact Factor: 3.17). 08/2008; 17(8):801 - 806. DOI: 10.1002/pds.1570

ABSTRACT In order to evaluate the previously published association between maternal use of selective serotonin re-uptake inhibitors (SSRI) and persistent pulmonary hypertension in the neonate (PPHN), we used data from the Swedish Medical Birth Register for the years 1997–2005. Infants were identified from discharge diagnoses, and maternal exposure to drugs from interviews performed in early pregnancy and from prescriptions from the antenatal care service. Putative confounders were studied: an increased risk for PPHN was indicated for high maternal age, for first parity, for maternal BMI, and possibly for maternal smoking. Adjusting for these variables and year of birth, an association between maternal use of SSRI and PPHN in births after 34 completed weeks was identified with a risk ratio of 2.4, 95%CI 1.2–4.3 when based on women who reported the drug use in early pregnancy. When a subgroup of the women were studied who also had prescriptions for SSRI from the antenatal care later in pregnancy, the risk estimate was 3.6, 95%CI 1.2–8.3. The risk estimates were lower than that described previously in the literature, but both estimates could come from the same about 4–5 times increased risk. The mechanism behind the association between SSRI and PPHN is unclear but an increased risk for respiratory problems after maternal use of SSRI is well known, and PPHN could be a rare part of this association. Copyright © 2008 John Wiley & Sons, Ltd.

0 Followers
 · 
73 Views
  • Source
    • " SSRIs neonatal exposure ( Boucher et al . , 2009 ) . Nevertheless , there is so far no report of serious neonatal complications , such as QT prolongation and persistent pulmonary hyperten - sion , which instead have been found to be associated ( in some but not all studies ) with neonatal SSRIs expo - sure ( Dubnov - Raz Juurlink et al . , 2008 ; Kallen et al . , 2008 ) . It should be said however that this association still remains a matter of debate and further investiga - tion in the scientific community ."
    [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVE: The present study provides a comprehensive review of the existing literature on the safety of serotonin-noradrenaline reuptake inhibitors (SNRIs) in pregnancy and lactation. METHODS: Studies published in English, reporting the use of SNRIs in pregnant and/or breastfeeding women, were identified by searching MEDLINE/Pubmed, PsycINFO, and EMBASE. RESULTS: Twenty-nine studies were included in the review. Altogether, the initial evidence coming from the reviewed studies suggests a lack of association between SNRIs and an increased risk of major congenital malformations. Conversely, exposure to SNRIs seems to be significantly associated with an increased risk of some perinatal complications. No neonatal adverse events emerged, so far, in the few studies concerning the safety of SNRIs during breastfeeding. CONCLUSIONS: Available data suggest that venlafaxine is relatively safe during pregnancy, in particular as far as major malformations are concerned, whereas considering the small number of studies published, no definitive conclusions can be drawn on its safety during breastfeeding. Because of the few studies so far published, the safety of duloxetine during pregnancy and breastfeeding remains to be well established
    Human Psychopharmacology Clinical and Experimental 03/2015; DOI:10.1002/hup.2473. · 1.85 Impact Factor
  • Source
    • " SSRIs neonatal exposure ( Boucher et al . , 2009 ) . Nevertheless , there is so far no report of serious neonatal complications , such as QT prolongation and persistent pulmonary hyperten - sion , which instead have been found to be associated ( in some but not all studies ) with neonatal SSRIs expo - sure ( Dubnov - Raz Juurlink et al . , 2008 ; Kallen et al . , 2008 ) . It should be said however that this association still remains a matter of debate and further investiga - tion in the scientific community ."
    [Show abstract] [Hide abstract]
    ABSTRACT: The present study provides a comprehensive review of the existing literature on the safety of serotonin-noradrenaline reuptake inhibitors (SNRIs) in pregnancy and lactation. Studies published in English, reporting the use of SNRIs in pregnant and/or breastfeeding women, were identified by searching MEDLINE/Pubmed, PsycINFO, and EMBASE. Twenty-nine studies were included in the review. Altogether, the initial evidence coming from the reviewed studies suggests a lack of association between SNRIs and an increased risk of major congenital malformations. Conversely, exposure to SNRIs seems to be significantly associated with an increased risk of some perinatal complications. No neonatal adverse events emerged, so far, in the few studies concerning the safety of SNRIs during breastfeeding. Available data suggest that venlafaxine is relatively safe during pregnancy, in particular as far as major malformations are concerned, whereas considering the small number of studies published, no definitive conclusions can be drawn on its safety during breastfeeding. Because of the few studies so far published, the safety of duloxetine during pregnancy and breastfeeding remains to be well established. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
    Human Psychopharmacology Clinical and Experimental 03/2015; 30(3). DOI:10.1002/hup.2473 · 1.85 Impact Factor
  • Source
    • "Studies have reported increased risk with adjusted odds ratios varying between 2.1 (95% CI 1.5 to 3.0) [104] to 6.1 (95% CI 2.2 to 16.8) [53]. Although research is conflicting, the general weight of the research, and the systematic review, suggest that late pregnancy SRI use seems to increase the risk of PPHN significantly. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Depression, anxiety, or both, during pregnancy are common complications during the perinatal period, with 15-20% of women experiencing depression at some point during their pregnancy. Considerable evidence suggests that untreated or undertreated maternal Axis I mood disorders can increase the risk for preterm birth, low birth weight, and alter neurobehavioral development in utero. Serotonin reuptake inhibitor antidepressants are often considered for antenatal therapy, with the goal of improving maternal mental health during pregnancy. Treatment with a serotonin-reuptake inhibitor, however, does not guarantee remission of depression, and in-utero serotonin reuptake inhibitor exposure has also been linked to increased risks for adverse infant outcomes. In this chapter, evidence linking serotonin reuptake inhibitor use with an increased risk for postnatal adaptation syndrome, congenital heart defects, and neonatal persistent pulmonary hypertension is reviewed. Management decisions should include attention to the continuum of depression symptoms, from subclinical to severe major depressive disorder and the long-term developmental risks that might also be associated with pre- and postnatal exposure.
    Best practice & research. Clinical obstetrics & gynaecology 09/2013; 28(1). DOI:10.1016/j.bpobgyn.2013.09.001 · 3.00 Impact Factor
Show more