Infants born to mothers who take SSRIs during late pregnancy face more than twice the risk of pulmonary hypertension compared with unexposed infants,
research finds.
Scandinavian data on 1.6 million infants showed 0.3% of those exposed to an SSRI in late pregnancy developed persistent pulmonary hypertension, compared with 0.12% of those never exposed.
Newborns exposed to an SSRI only in early pregnancy had a less marked, but still significant, increased risk, with 0.19% experiencing persistent pulmonary hypertension, the study found.
The authors said persistent pulmonary hypertension of the newborn was a rare disease, with an absolute risk as low as 1-2 per 1000 infants in the general population.
"However, as the risk in association with treatment in late pregnancy seems to be more than doubled, we recommend caution when treating pregnant women with SSRIs," they wrote in the BMJ.
"It is essential to plan the treatment and to weigh the risks of persistent pulmonary hypertension of the newborn when treating women in late pregnancy with those of relapse of depression and neonatal abstinence syndrome if therapy is interrupted."
Dr Debra Kennedy, director of the MotherSafe service at the Royal Hospital for Women in Sydney, said she routinely advised women that research suggested a link between SSRI use in later pregnancy and neonatal pulmonary hypertension.
"We say to people you need to be aware that it can happen, and therefore you don't have a home delivery and you probably don't go home too soon after you've had your baby," she said.
"It's really just about letting people know there may be some increased risks, but probably in many cases it's less safe to not take the medication."
The study included data on 11,014 mothers who had filled a prescription for an SSRI during late pregnancy, and 17,053 who filled one during early pregnancy only.
Mothers taking SSRIs were generally older and more likely to be smokers than those not on SSRIs.