New research is out today talking about the use of selective serotonin reuptake inhibitors (SSRIs) in pregnancy and how that has been shown in their study to increase the risks of a newborn problem known as persistent pulmonary hypertension in the newborn (PPH). PPH is also known as persistent fetal circulation. Children's Hospital of Colorado explains what's supposed to happen at birth like this:
Normally, when a baby is born and begins to breathe air, his circulatory system quickly adapts to the outside world. The pressure in the lungs changes as air enters and inflates the lungs. As a result, the ductus arteriosus, which previously supplied the fetal heart with blood, permanently closes. Blood returning to the heart from the body can now be pumped into the lungs, where oxygen and carbon dioxide are exchanged.
So the study today says that there may be an increase risk, nearly double, if a mother is taking SSRIs in pregnancy. Don't go screaming off to the doctor about your prescriptions just yet, however. There are a couple of things to keep in mind, the first is, that, while this was a large study, it was an observational study, this does not proven that the SSRIs caused the PPH. Secondly, the absolute risk, meaning how many babies will actually be affected, if this were a cause, is very low. About 1.2 cases of PPH are found per 1,000 live births, so if this study is true, we're talking 3 cases per 1,000.
What should you do if you're taking an SSRI in pregnancy or are considering pregnancy?
- Talk to your doctor about your prescriptions. This includes your prescribing doctor and your OB or midwife.
- If you aren't yet pregnant, be sure to have this discussion at a preconceptional health visit. Perhaps there are other anti-depressants that you can switch to or other therapies to try prior to pregnancy.
- Ask about the specific risk to you and your pregnancy. The risk of not taking the medication may be greater for you than the risk of the PPH.
- Realize that there is still a lot of research to be done. Studies have varied on this topic.
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Related:
- Depression in Pregnancy
- Antidepressants and Pregnancy
- Readers Share: How do you deal with depression in pregnancy?
- Do you have postpartum depression? Quiz
- Signs of Postpartum Depression
- Medications That Alter Pregnancy Test Results
Source:
Kieler H, et al "Selective serotonin reuptake inhibitors during pregnancy and risk of persistent pulmonary hypertension in the newborn: population-based cohort study from the five Nordic countries" BMJ 2012; DOI:10.1136/bmj.d8012.
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So nice to see an article stressing the importance of talking to your doctor about your health instead of ignoring the possibility that risk vs possible complications! Some people need these valuable medications and because someone else who had a birth defect while on it will be telling you to avoid it at all costs, their situation is not definiative that it will happen to you. Your health vs a 3 in 1,000 chance that something could go wrong. Talking with your doctor is a good thing. You can find something you are comfortable with. Do your research on your own. I recently had to do that with one of my doctors and you’ll be amazed at how much the doctors respect you doing your own research to find what will work for you and what you are comfortable taking.
Mandy,
It’s hard when studies like these come out. People aren’t really equipped to look at the studies and the news articles about the studies often don’t give much other than the scare factor. Who am I, or a reporter, or anyone to tell a woman what is the best decision for her? But what I can give someone is what that really means in terms of numbers, the absolute risks, versus the DOUBLE language which sounds awful. My mantra is that double a very small number is still a very small number.