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

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.