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Study Substantiates Link Between Antidepressants and PPHN

Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant medication widely prescribed in the U.S. and around the world. One of the most popular SSRIs is Zoloft, which was first marketed in 1991 by Pfizer. Since that time, Zoloft and other SSRI medications have been linked to serious side effects, including birth defects.

Now, a new study published in the British Medical Journal adds further proof to the link between antidepressants and PPHN, or persistent pulmonary hypertension of the newborn (PPHN).

Researchers evaluated prior studies

The study was published on January 14 by Canadian scientists. Researchers evaluated information from seven studies that had been rigorously screened for quality from a selection of 3,077 abstracts. The researchers determined that there may be a difference in the risk of PPHN based on when the patient took the drug in her pregnancy.

“A significant relation for exposure to SSRIs in early pregnancy was not evident,” concluded the researchers. However, there was an increased risk of PPHN when the antidepressant was taken later in the pregnancy, although the researchers noted that the risk was still relatively low.

For prospective parents, even a low risk of PPHN with prenatal exposure to Zoloft is unacceptable. PPHN, also known as persistent fetal circulation, is a condition in which the blood flow of the child mimics that of the blood flow of a fetus. The blood bypasses the lungs. This means that the lungs have trouble exchanging oxygen and carbon dioxide, giving the baby dangerously low blood oxygen levels. Since organs need a certain amount of oxygen to function properly, they can become easily damaged with PPHN. PPHN may lead to life-threatening complications, including brain hemorrhage, seizure, chronic lung disease, organ failure, kidney damage, and neurological deficits, such as developmental delays. In severe cases, the child may not survive.

FDA warns of PPHN and antidepressant use

In 2006, the FDA issued a warning regarding the use of antidepressants and risks of PPHN. The agency stated that the use of Zoloft and other SSRIs during pregnancy could raise the risk of this particular birth defect. However, in 2011, the agency issued a new safety communication stating that more research was needed for conclusive evidence. However, in that same announcement, the FDA indicated that all drug labels for SSRIs would be updated to reflect the potential risk.

SSRIs linked to other serious risks

Antidepressants have been linked to more than just PPHN. In fact, one of the most commonly reported side effects is heart defects. Zoloft and other SSRIs have been known to cause atrial septal defects (ASD) and ventricular septal defects (VSD). Both of these defects cause holes in the walls of the heart’s chambers. This can cause high blood pressure in the lungs and reduced oxygen available to the organs.

SSRI birth defects may also include omphalocele, which occurs when the baby’s intestines or other abdominal organs push through to the outside of the abdomen. Surgery is required to replace the organs.

Some babies who have been exposed to SSRIs in the womb have been born with craniosynostosis. In normal development, the bones of a baby’s skull are not yet closed. Craniosynostosis occurs when the bones prematurely close, preventing the brain from developing properly and leading to complications such as blindness, seizures, and developmental delays.

  1. BMJ, Prenatal exposure to antidepressants and persistent pulmonary hypertension of the newborn: systematic review and meta-analysis,

  2. Children’s Hospital of Wisconsin, Persistent Pulmonary Hypertension,