The use of antidepressants by mothers during late pregnancy may be associated with a small increased risk of their baby developing a potentially-fatal condition that makes it difficult for their heart to pump blood through their arteries, research has found.
Around two in every 1,000 newborn babies are affected by persistent pulmonary hypertension of the newborn (PPHN) in the UK, which occurs when a newborn’s circulation system in its lungs does not adapt to breathing outside of the womb.
But the study carried out in the US found this went up to around three in 1,000 where the mother had used an antidepressant during the last 90 days of pregnancy.
The severe condition has a 10 per cent-20 per cent mortality rate and long-term health consequences include chronic lung disease, seizures, and neuro-developmental problems.
The study, which was conducted by Brigham and Women’s Hospital in Boston, Massachusetts, examined the risk of PPHN associated with both selective serotonin reuptake inhibitor (SSRI) antidepressants and non-SSRI antidepressants among more than three million pregnant women.
They found 3.4 per cent of these women used an antidepressant during the 90 days before delivery: 2.7 per cent took an SSRI and 0.7 per cent a non-SSRI.
Overall, 20.8 per 10,000 infants not exposed to antidepressants during the last 90 days of pregnancy had PPHN compared with 31 per 10,000 that were exposed.
This higher risk was observed for both SSRI (31.5 per 10,000 infants) and non-SSRI (29.1 per 10,000 infants) antidepressants.
Patrick O’Brien, of the Royal College of Obstetricians and Gynaecologists (RCOG), described the research as “extremely useful” and the largest on the issue to date.
“The findings therefore, are certainly the best evidence we currently have on antidepressant use in late pregnancy and the risk of PPHN,” he said.
“In a sense, these results are reassuring. The findings suggest a very small absolute risk. The chances of a baby getting PPHN when its mother was not taking an SSRI are around two in 1,000, compared to around three in 1,000 when the mother had taken an SSRI antidepressant medication in the last 90 days of pregnancy.
“Depression in pregnancy can be very serious for a woman and can also impact on the health of her baby, so we must consider the benefits of antidepressant medication in such cases.
“Our continued advice for pregnant women suffering with depression would be that the benefits outweigh the risks, however, all pros and cons should be discussed and weighed up by a woman, together with her obstetrician.”
The study is published online in the journal JAMA.