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SSRIs and PPHN in Newborns

Selective Serotonin Reuptake Inhibitors (SSRIs) are a form of antidepressants. In July 2007, a study regarding SSRIs was conducted by the Centers for Disease Control and Prevention (CDC) and published in the New England Journal of Medicine. The study revealed that mothers who took SSRIs such as Paxil®, Prozac®, and Zoloft® during the second half of their pregnancy had a greater risk of having children with Persistent Pulmonary Hypertension (PPHN) than mothers who did not take the medication. PPHN is a respiratory disorder that causes the normal circulatory transition that occurs after birth to fail. In turn, the newborn is unable to provide itself enough oxygen-rich blood.

Researchers found through this study that women who took SSRIs during the second half of their pregnancy were unknowingly increasing the risk of PPHN affecting their child by nearly six times the normal risk. Typically, PPHN is a disorder that affects one in two infants per 1000 births. But according to data from this study, when SSRIs are used in the second half of pregnancy the risk of PPHN can increase to five to six times for every 1000 live births.

SSRIs have also been found to cause other birth defects.

More birth defects that can be caused by SSRIs are:

  • Anencphaly-When a child is born without a forebrain

  • Omphalocele-When a child is born with his or her organs on the exterior of the body

  • Craniosynostosis-When the bones of the child’s bones prematurely close

Newborns whose mothers took SSRIs during the second half of their pregnancy were also found to experience withdrawal symptoms. These symptoms could cause the child to feel irritable, have a high-pitched or weak cry, go through tremors, have weak muscle tone, experience respiratory stress, and have trouble sleeping.

Paxil® Linked to the Risk of Heart Defects in Infants

On December 8, 2005, a Public Health Advisory was issued by the U.S. Food and Drug Administration (FDA) regarding Paxil® (paroxetine) and its link to heart defects in newborns. The advisory was issued following two studies that took an in-depth look at how this medication affected women during the first three months of their pregnancy.

One study used data from the Swedish national registry and it found that women who took Paxil® in their first trimester, which is the first three months of pregnancy, doubled the risk of having a child with a heart defect. The second study also linked Paxil® to cardiac problems and was conducted by researchers who collected data from U.S. insurance claims. This U.S. based study found that mothers who took the drug while in their first trimester were putting their child at a 50% greater risk of having heart problems than mothers who didn’t take the medication.

Some of the most common cardiac problems associated with Paxil® use during pregnancy were atrial and ventricular septal defects. Both of these conditions involve the deformity of the wall between the right and left side of the heart. A ventricular septal defect (VSD) is where the wall, which divides the left and right ventrides of the heart, is defected. An atrial septal defect (ASD) is when the inter-atrial septum of the heart is negatively affected. Though both of these defects can range in severity and may get better with treatment, there are cases that involve larger defects and may require the child to undergo surgery.

Smoking While Pregnant and Taking Antidepressants Shown to Increase Risk of Birth Defects

An international study conducted In December of 2008, showed the link between the use of Prozac® and Paxil® by pregnant women and cardiovascular problems in children. The study took place in Israel, Italy, and Germany. It found that women who are taking antidepressants and smoke, greatly increase their child’s chances of having heart defects. The study also found that the use of these medications while pregnant may also cause neurodevelopment defects or functional problems.

Smoking cigarettes alone while pregnant is also found to increase the risk of cardiac problems in newborns. Women who take antidepressants like Paxil® and Prozac® are more likely to smoke cigarettes.

Have you or your child experienced health problems as the result of taking antidepressants?

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