SSRIs and Newborns: Persistent Pulmonary Hypertension

Selective Serotonin Reuptake Inhibitors (SSRIs) comprise a class of anti-depressant drugs that are widely prescribed for depressive and anxiety disorders. These SSRI drugs include the following:

Prozac® (fluoxetine)
Paxil® (paroxetine)
Zoloft® (sertraline)
Celexa® (citalopram)
Cipralex® (escitalopram)
Luvox® (fluvoxamine)
Remeron® (mirtazapine)
Effexor® (venlafaxine).

Recent studies suggest that the use of these SSRI drugs during pregnancy may increase the risk of birth defects.

SSRIs and Ompahlocele, Craniosynostosis and Anencephaly
A study published in the June 28, 2007 issue of the New England Journal of Medicine (NEJM) indicates that maternal use of SSRIs during pregnancy significantly increases the risk of ompahlocele, craniosynostosis and anencephaly. This study (Use of Selective Serotonin-Reuptake Inhibitors in Pregnancy and the Risk of Birth Defects, Alwan et. al.) suggests that the risk of these birth defects is almost tripled (Odds Ratio 2.8) when SSRIs are used during pregnancy. The Study further indicates that the risk of these birth defects is:

4.2 times greater with the use of Paxil® during pregnancy
4.0 times greater with the use of citralopram during pregnancy
2.0 times greater with the use of Zoloft® during pregnancy, and
1.9 times greater with the use of Prozac® during pregnancy.

Paxil® and Neonatal Cardiac Malformations
Two recent studies suggest that a pregnant woman’s use of Paxil® during the first trimester of pregnancy increases the risk that her child may be born with a cardiac abnormality. One study, based on data collected from the Swedish national registry, demonstrated a doubling of the risk of cardiac abnormalities for babies born to women who used Paxil® during early pregnancy. The most common abnormalities were ventricular septal defects (VSD) and atrial septal defects (ASD). The second study, based on data available in a U.S. insurance claims database, showed a 50% increase in the risk of cardiac abnormalities for babies born to women who used Paxil® during the first trimester of pregnancy. Again, the most common neonatal cardiac defects were ventricular septal defects (VSD) and atrial septal defects (ASD).

If you or someone you know was taking Paxil® and gave birth to a baby who suffered from cardiac or other birth defects, please click HERE to tell us more about the situation and find out more about your or her legal rights.

SSRIs and Persistent Pulmonary Hypertension (PPHN)

A recently published study that appeared in the prestigious New England Journal of Medicine indicates that the use of certain anti-depressant medications during the latter half of pregnancy may increase the risk that the newborn will develop a serious respiratory disorder known as Persistent Pulmonary Hypertension (PPHN).

Data from this study indicate that the use of Selective Serotonin Reuptake Inhibitors (SSRIs) such as Prozac®, Zoloft®, or Paxil® during the second half of pregnancy may increase the risk of Persistent Pulmonary Hypertension (PPHN) by as much as six times the normal risk. Historically, Persistent Pulmonary Hypertension (PPHN) occurs in 1-2 infants per 1,000 live births. However, data from this study suggest that when Selective Serotonin Reuptake Inhibitors (SSRIs) such as Prozac®, Zoloft® and Paxil® are used by a woman during the second half of her pregnancy, the rate of Persistent Pulmonary Hypertension (PPHN) increases to 5-6 cases per 1,000 live births.

Persistent Pulmonary Hypertension (PPHN) is a serious pulmonary (respiratory) disorder that can develop in newborn babies and impairs the ability to supply oxygen-rich blood to the body. When a newborn suffers from Persistent Pulmonary Hypertension (PPHN), the pulmonary arteries (blood vessels in the lungs) fail to fully open, i.e. these arteries remain constricted. Because of this, the newborn is unable to oxygenate his/her blood. As a result, the infant cannot provide an adequate supply of oxygen-rich blood to his/her tissues and organs. Without an adequate supply of oxygen-rich blood, the infant can suffer serious complications.