Selective Serotonin Reuptake Inhibitors and Persistent Pulmonary Hypertension of the Newborn: An Update Meta-Analysis

Area of Science:

• Perinatal Medicine
• Neonatal Health
• Pharmacovigilance

Background:

• Persistent pulmonary hypertension of the newborn (PPHN) is a severe condition with significant mortality and morbidity.
• Previous research suggests a potential association between maternal use of selective serotonin reuptuptake inhibitors (SSRIs) and the risk of PPHN.

Purpose of the Study:

• To conduct an up-to-date review and meta-analysis on the association between maternal SSRI use during pregnancy and the risk of PPHN.

Main Methods:

• Systematic review and random-effects meta-analysis of 9 cohort and case-control studies.
• Searched PubMed, Medline, EMBASE, Web of Science, and Google Scholar for relevant English articles published between 1960 and 2017.

Main Results:

• Meta-analysis of 8 studies involving 7,540,265 subjects revealed a significantly increased risk of PPHN with maternal SSRI use (pooled OR: 1.516).
• The absolute increase in PPHN risk was modest (0.619 per 1000 livebirths), with a number needed to harm of 1615 women.

Conclusions:

• Maternal SSRI use during pregnancy is associated with significantly greater odds of PPHN.
• The clinical significance of this association is modest and likely outweighed by the benefits of treating perinatal depression.
• Further research, including robust longitudinal or randomized controlled studies, is needed to investigate this association.