Antidepressant medication use and risk of persistent pulmonary hypertension of the newborn

Authors

  • Susan E. Andrade ScD,

    Corresponding author
    1. Meyers Primary Care Institute, University of Massachusetts Medical School, the Fallon Foundation, and Fallon Community Health Plan, Worcester, MA, USA
    2. The HMO Research Network Center for Education and Research in Therapeutics, Boston, MA, USA
    • Meyers Primary Care Institute, 630 Plantation Street, Worcester, MA 01605, USA.
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  • Heather McPhillips MD, MPH,

    1. The HMO Research Network Center for Education and Research in Therapeutics, Boston, MA, USA
    2. Department of Pediatrics, University of Washington, Seattle, WA, USA
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  • David Loren MD,

    1. Department of Pediatrics, University of Washington, Seattle, WA, USA
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  • Marsha A. Raebel PharmD,

    1. The HMO Research Network Center for Education and Research in Therapeutics, Boston, MA, USA
    2. Kaiser Permanente Colorado, Denver, CO, USA
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  • Kimberly Lane MPH,

    1. The HMO Research Network Center for Education and Research in Therapeutics, Boston, MA, USA
    2. Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA, USA
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  • James Livingston MBA,

    1. The HMO Research Network Center for Education and Research in Therapeutics, Boston, MA, USA
    2. Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA, USA
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  • Denise M. Boudreau PhD,

    1. The HMO Research Network Center for Education and Research in Therapeutics, Boston, MA, USA
    2. Center for Health Studies, Group Health Cooperative, Seattle, WA, USA
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  • David H. Smith PhD,

    1. The HMO Research Network Center for Education and Research in Therapeutics, Boston, MA, USA
    2. Kaiser Permanente Northwest, Portland, OR, USA
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  • Robert L. Davis MD, MPH,

    1. The HMO Research Network Center for Education and Research in Therapeutics, Boston, MA, USA
    2. Center for Health Research, Kaiser Permanente Southeast, Atlanta, GA, USA
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  • Mary E. Willy PhD,

    1. Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA
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  • Richard Platt MD, MS

    1. The HMO Research Network Center for Education and Research in Therapeutics, Boston, MA, USA
    2. Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA, USA
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  • The views expressed herein are those of the authors and not necessarily those of the Food and Drug Administration.

Abstract

Purpose

To determine the prevalence of persistent pulmonary hypertension of the newborn (PPHN) among infants whose mothers were exposed to antidepressants in the third trimester of pregnancy compared to the prevalence among infants whose mothers were not exposed to antidepressants in the third trimester.

Methods

A retrospective study was conducted using the automated databases of four health plans participating in the HMO Research Network Center for Education and Research on Therapeutics. Women who delivered an infant in a hospital from 1 January 1996 through 31 December 2000 were identified. The administrative databases were used to identify full-term infants whose mothers received an antidepressant during the third trimester of pregnancy and unexposed infants whose mothers did not receive an antidepressant during the third trimester. Hospitalization data were used to identify diagnoses or procedure codes potentially indicative of PPHN.

Results

Among 1104 infants exposed to antidepressants in the third trimester and a matched sample of 1104 unexposed infants, five infants were classified by the expert reviewers as having PPHN. Among those infants whose mothers were exposed to selective serotonin reuptake inhibitors (SSRIs) in the third trimester, the prevalence of PPHN was 2.14 per 1000 (95% confidence interval (CI) 0.26, 7.74), while the prevalence among infants whose mothers were not exposed was 2.72 per 1000 (95%CI 0.56, 7.93).

Conclusions

We did not find an association between SSRI use in late pregnancy and PPHN. Limitations of the present study, including the small number of confirmed cases, suggest further research in this area may be warranted. Copyright © 2009 John Wiley & Sons, Ltd.

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