Maternal serotonin reuptake inhibitor use may increase risk for persistent pulmonary hypertension of the newborn

  • Ng QX & al.
  • J Womens Health (Larchmt)
  • 8 Nov 2018

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Use of selective serotonin reuptake inhibitor (SSRI) during pregnancy is associated with an increased risk for persistent pulmonary hypertension of the newborn (PPHN).
  • Risk for PPHN associated with SSRI use might not warrant the withdrawal of therapy, as previous studies showed that untreated perinatal depression presents additional adverse outcomes.

Why this matters

  • The prevalence of maternal depression, and consequent use of antidepressants is rising worldwide.
  • The use of SSRIs during pregnancy to treat antenatal depression remains a challenge.

Study design

  • Meta-analysis of 9 studies, involving 7,540,265 women with SSRIs use during pregnancy, identified after search across electronic databases.
  • Funding: None.

Key results

  • Using random effects model, the pooled results of 8 trials showed that use of SSRI during pregnancy was associated with increased risk for PPHN (OR, 1.516; 95% CI, 1.035-1.997; P<.001>
  • Overall, the absolute increase in risk for PPHN with SSRI use was small with an absolute risk difference of 0.619/1000 livebirth and a number needed to harm of 1615 women.

Limitations

  • All potential confounders were not adjusted.
  • Diagnostic criteria and definition of PPHN differed among studies.

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