Date of Graduation

8-14-2010

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

James Ferguson PA-C, MPH

Second Advisor

Annjanette Sommers MS, PAC

Third Advisor

Rob Rosenow PharmD, OD

Abstract

Background: Persistent pulmonary hypertension of the newborn (PPHN) is a rare but serious and potentially fatal clinical condition. Recent reports have suggested a possible association with the development of PPHN in the neonate, to mothers who have been exposed in the later stages of pregnancy to selective serotonin re-uptake inhibitors (SSRI), an antidepressant medication. This review will investigate the most recent literature to determine the prevalence of PPHN among mothers exposed to SSRIs in late pregnancy.

Methods: A systematic review of the literature published in the previous five years was conducted on the MEDLINE, CINAHL, and ISI World of Science databases using the keywords PPHN, SSRI, and pregnancy. Articles that examined outcomes of PPHN with SSRI exposure in pregnancy after 20 gestational weeks were selected. Research that focused on antidepressant use other than SSRIs or outcomes with early exposure during pregnancy was excluded.

Results: Three articles that investigated the effects of SSRI exposure in late pregnancy and PPHN were analyzed for significant results. Two of the three articles agreed that there is an almost six fold increase in PPHN in infants exposed to SSRIs later in pregnancy. One study found no significant difference in the prevalence of PPHN and SSRI use in the third trimester of pregnancy.

Conclusion: The data reviewed suggests that there is a possible connection with SSRI exposure in late pregnancy and the development of PPHN in infants. However, the data at this time are limited and not conclusive. The information gathered in this systematic review should be considered in the decision to initiate, continue, or discontinue an SSRI during pregnancy.

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