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Published Online: 1 February 2012

Persistent Pulmonary Hypertension of the Newborn and Selective Serotonin Reuptake Inhibitors: Lessons From Clinical and Translational Studies

Abstract

The authors review the incidence of persistent pulmonary hypertension in newborns of women treated with SSRIs. Three of six studies showed elevated risk, but all failed to control fully for the possible effects of depression itself, including shorter fetal gestation periods. While persistent pulmonary hypertension is rare, about one-fourth of infants exposed to SSRIs experience a short-lived neonatal adaptation syndrome, including jitteriness, fussiness, gastrointestinal distress, feeding difficulties, and poor temperature regulation. Tachypnea and other symptoms of transient respiratory distress may present earlier.

Abstract

Abstract:

Two recent studies linking in utero exposure to selective serotonin reuptake inhibitors (SSRIs) with persistent pulmonary hypertension of the newborn (PPHN), a potentially serious but rare respiratory illness, have made clinicians and patients more reluctant to use SSRIs during pregnancy. However, additional clinical studies have associated maternal depression rather than SSRI exposure as a risk factor for PPHN. This review summarizes the current knowledge regarding PPHN pathophysiology, including the role of serotonin and genetic risk factors; the effects of SSRIs on pulmonary vasculature; the possible link between SSRIs and PPHN; and the diagnosis, clinical management, and prognosis of PPHN.

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Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Pages: 134 - 140
PubMed: 22420034

History

Received: 6 April 2011
Revision received: 25 August 2011
Accepted: 6 September 2011
Published online: 1 February 2012
Published in print: February 2012

Authors

Details

Mallay Occhiogrosso, M.D.
From the Department of Psychiatry at Weill Cornell Medical College in New York.
Setareh Salehi Omran
From the Department of Psychiatry at Weill Cornell Medical College in New York.
Margaret Altemus, M.D.
From the Department of Psychiatry at Weill Cornell Medical College in New York.

Notes

Address correspondence to Dr. Occhiogrosso ([email protected]).

Funding Information

The authors report no financial relationships with commercial interests.

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