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Systematic review and meta-analysis
Exposure to selective serotonin reuptake inhibitors in late pregnancy increases the risk of persistent pulmonary hypertension of the newborn, but the absolute risk is low
  1. Nancy Byatt1,
  2. Marlene P Freeman2
  1. 1Department of Psychiatry and Obstetrics and Gynecology, University of Massachusetts Medical School/UMass Memorial Medical Center, Worcester, Massachusetts, USA;
  2. 2Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital, Boston, Massachusetts, USA
  1. Correspondence to: Dr Nancy Byatt, Department of Psychiatry and Obstetrics and Gynecology, University of Massachusetts Medical School/UMass Memorial Medical Center, 55 Lake Avenue North, Worcester, MA 01655, USA; nancy.byatt{at}umassmemorial.org

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Implications for practice and research

  • Persistent pulmonary hypertension in newborns (PPHN) is rare and, despite a small increased risk when selective serotonin reuptake inhibitors (SSRIs) are used in late pregnancy, the absolute risk of PPHN remains low.

  • Considering the risk of relapse into depression, the available evidence does not support discontinuation of SSRIs during pregnancy due to concerns about PPHN.

  • Future research needs to consistently either examine or control for factors that may be associated with PPHN, including treatments for underlying maternal psychiatric illness.

Context

Depression in pregnancy is common and has adverse effects on birth outcomes, mother–infant attachment, and the behaviour and development of infants and children.1–4 While effective …

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