SSRI and SNRI use during pregnancy and the risk of persistent pulmonary hypertension of the newborn.
Br J Clin Pharmacol. 2016 Nov 22. Epub 2016 Aug 22. PMID: 27874994
AIM: Use of selective serotonin reuptake inhibitors (SSRIs) in late pregnancy may be associated with an increased risk of persistent pulmonary hypertension of the newborn (PPHN). Limited data are available on the risk of PPHN associated with serotonin norepinephrine reuptake inhibitors (SNRIs). We aimed to quantify both associations.
METHODS: Using data from the Quebec Pregnancy Cohort between 1998 and 2009, we included women covered by the provincial drug plan who had a singleton live birth. Exposure categories were SSRI, SNRI, and other antidepressant use; non-users were considered the reference category. Generalized estimating equation models were used to obtain risk estimates and 95% confidence intervals (CIs). Confounding by indication was minimized by adjusting for history of maternal depression/anxiety before pregnancy.
RESULTS: Overall 143,281 pregnancies were included; PPHN was identified in 0.2% of newborns. Adjusting for maternal depression, and other potential confounders, SSRI use during the second half of pregnancy was associated with an increased risk of PPHN (aOR 4.29, 95%CI 1.34, 13.77) compared to non-use of antidepressants; SNRI use during the same time-window was not statistically associated with the risk of PPHN (aOR 0.59, 95%CI 0.06, 5.62). Use of SSRIs and SNRIs before the 20(th) week of gestation was not associated with the risk of PPHN.
CONCLUSIONS: Use of SSRIs in the second half of pregnancy was associated with the risk of PPHN. Given our results on SNRIs and the lack of statistical power for these analyses, it is unclear whether SNRI use during pregnancy also increases the risk of PPHN. This article is protected by copyright. All rights reserved.