In the past we have written several articles explaining the potential risks a mother takes when taking anti-depressant drugs while pregnant. Selective Serotonin Reuptake Inhibitors, better known as SSRI’s, have already been linked to septal heart defects, and amphibole. And, now, yet another study confirms another possible birth defect– dangerously high blood pressure in the infant’s lungs, persistent pulmonary hypertension (PPHN).
According to a study published Friday, January 13, 2012 in the British Medical Journal, taking SSRI’s, such as Prozac, after the 20th week of pregnancy more than doubled the risk of persistent pulmonary hypertension.
SSRI’s are a class of compounds typically used to treat depression, anxiety disorders, and some personality disorders.
Persistent pulmonary hypertension in newborns (PPHN) is a respiratory disorder in which the arteries leading to the lungs remain constricted after birth, limiting blood flow and oxygen.
Risk factors for PPHN include maternal obesity, diabetes, and smoking, and between 5% and 10% babies with the disorder do not survive.
But, this is not the first study of it’s kind confirming this link. A 2006 study first linked SSRI use during pregnancy to the disorder, finding a sixfold increase in the incidence of neonatal pulmonary hypertension in babies exposed to the antidepressants in the last months before birth.
However, studies conducted since then have been mixed, with some supporting the association and others finding no increase in risk associated with SSRI use.
This new study that again links the 2 together was led by Helle Kieler at the Karolinska Institute’s Centre for Pharmacoepidemiology in Stockholm. The researchers looked at 1.6 million single births between 1996 and 2007 in Denmark, Finland, Iceland, Norway and Sweden.
In the general population, the number of newborns with the condition is 1.2 in 1,000, with a mortality rate among babies with high blood pressure in the lungs of 15 percent.
Newborns of some 17,000 mothers who filled out prescriptions for SSRIs before the eighth week of pregnancy showed a slight increased risk of having the condition.
But for 11,000 expectant mothers who took the drugs after week 20 of their pregnancies, the risk more than doubled.
Even for this group, however, the absolute risk for newborns remained fairly low: about three in 1,000, or a 0.2 percent, the researchers said.
Kieler nonetheless suggested that doctors who treat depression in pregnant patients consider a non-drug approach to the condition.
“As the risk in association with treatment in late pregnancy seems to be more than doubled, we recommend caution when treating pregnant women with SSRIs,” the researchers concluded.
The drugs analyzed in this study included; fluoxetine, citalopram, paroxetine, sertraline, fluvoxamine and escitalopram. Fluoxetine is better known under the brand name Prozac.
Last month, the FDA sent a letter to health care professionals warning about a possible risk for persistent pulmonary hypertension in newborns born to women who take SSRIs during pregnancy.
The advisory noted that “there have been conflicting findings from new studies evaluating this potential risk, making it unclear whether use of SSRIs during pregnancy can cause PPHN.”