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Previous Volume 354:579-587 February 9, 2006 Number 6 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Editorial by Mills, J. L. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

Background Persistent pulmonary hypertension of the newborn (PPHN) is associated with substantial infant mortality and morbidity. A previous cohort study suggested a possible association between maternal use of the selective serotonin-reuptake inhibitor (SSRI) fluoxetine late in the third trimester of pregnancy and the risk of PPHN in the infant. We performed a case–control study to assess whether PPHN is associated with exposure to SSRIs during late pregnancy.

Methods Between 1998 and 2003, we enrolled 377 women whose infants had PPHN and 836 matched control women and their infants. Maternal interviews were conducted by nurses, who were blinded to the study hypothesis, regarding medication use in pregnancy and potential confounders, including demographic variables and health history.

Results Fourteen infants with PPHN had been exposed to an SSRI after the completion of the 20th week of gestation, as compared with six control infants (adjusted odds ratio, 6.1; 95 percent confidence interval, 2.2 to 16.8). In contrast, neither the use of SSRIs before the 20th week of gestation nor the use of non-SSRI antidepressant drugs at any time during pregnancy was associated with an increased risk of PPHN.

Conclusions These data support an association between the maternal use of SSRIs in late pregnancy and PPHN in the offspring; further study of this association is warranted. These findings should be taken into account in decisions as to whether to continue the use of SSRIs during pregnancy.

Source Information

From the Departments of Pediatrics (C.D.C., K.L.J.) and Family and Preventive Medicine (C.D.C.), University of California, San Diego, La Jolla; the Slone Epidemiology Center, Boston University School of Public Health, Boston (S.H.-D., M.M.W., C.L., A.A.M.); and Children's Hospital and Brigham and Women's Hospital, Harvard Medical School, Boston (L.J.V.M.).

Address reprint requests to Dr. Chambers at the University of California, San Diego, Medical Center, 200 W. Arbor Dr., Mail Code 8446, San Diego, CA 92103, or at chchambers{at}ucsd.edu.

Full Text of this Article

Related Letters:

Selective Serotonin-Reuptake Inhibitors and Persistent Pulmonary Hypertension of the Newborn
Reefhuis J., Rasmussen S. A., Friedman J. M., Hallberg P., Odlind V., Sjöblom V., Chambers C., Hernandez-Diaz S., Mitchell A. A.
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N Engl J Med 2006; 354:2188-2190, May 18, 2006. Correspondence

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