Persistent pulmonary hypertension of the newborn and selective serotonin reuptake inhibitors: lessons from clinical and translational studies

Am J Psychiatry. 2012 Feb;169(2):134-40. doi: 10.1176/appi.ajp.2011.11040553.

Abstract

Two recent studies linking in utero exposure to selective serotonin reuptake inhibitors (SSRIs) with persistent pulmonary hypertension of the newborn (PPHN), a potentially serious but rare respiratory illness, have made clinicians and patients more reluctant to use SSRIs during pregnancy. However, additional clinical studies have associated maternal depression rather than SSRI exposure as a risk factor for PPHN. This review summarizes the current knowledge regarding PPHN pathophysiology, including the role of serotonin and genetic risk factors; the effects of SSRIs on pulmonary vasculature; the possible link between SSRIs and PPHN; and the diagnosis, clinical management, and prognosis of PPHN.

Publication types

  • Review

MeSH terms

  • Antidepressive Agents / administration & dosage
  • Antidepressive Agents / adverse effects
  • Clinical Trials as Topic
  • Cohort Studies
  • Depressive Disorder* / complications
  • Depressive Disorder* / physiopathology
  • Female
  • Humans
  • Infant, Newborn
  • Maternal-Fetal Exchange
  • Maternal-Fetal Relations
  • Persistent Fetal Circulation Syndrome* / epidemiology
  • Persistent Fetal Circulation Syndrome* / etiology
  • Persistent Fetal Circulation Syndrome* / physiopathology
  • Pregnancy
  • Pregnant Women / psychology*
  • Prenatal Exposure Delayed Effects / etiology*
  • Risk Factors
  • Selective Serotonin Reuptake Inhibitors / administration & dosage
  • Selective Serotonin Reuptake Inhibitors / adverse effects*
  • Serotonin Plasma Membrane Transport Proteins / genetics
  • Translational Research, Biomedical

Substances

  • Antidepressive Agents
  • Serotonin Plasma Membrane Transport Proteins
  • Serotonin Uptake Inhibitors