title: Selective serotonin reuptake inhibitors during pregnancy and risk of persistent pulmonary hypertension in the newborn: population based cohort study from the five Nordic countries.
abstract: OBJECTIVE
  To assess whether maternal use of selective serotonin reuptake inhibitors (SSRIs) increases the risk of persistent pulmonary hypertension in the newborn, and whether such an effect might differ between specific SSRIs.
  
  
  METHODS
  Population based cohort study using data from the national health registers.
  
  
  METHODS
  Denmark, Finland, Iceland, Norway, and Sweden, 1996-2007.
  
  
  METHODS
  More than 1.6 million infants born after gestational week 33.
  
  
  METHODS
  Risks of persistent pulmonary hypertension of the newborn associated with early and late exposure to SSRIs during pregnancy and adjusted for important maternal and pregnancy characteristics. Comparisons were made between infants exposed and not exposed to SSRIs.
  
  
  RESULTS
  Around 30 000 women had used SSRIs during pregnancy and 11 014 had been dispensed an SSRI later than gestational week 20. Exposure to SSRIs in late pregnancy was associated with an increased risk of persistent pulmonary hypertension in the newborn: 33 of 11 014 exposed infants (absolute risk 3 per 1000 liveborn infants compared with the background incidence of 1.2 per 1000); adjusted odds ratio 2.1 (95% confidence interval 1.5 to 3.0). The increased risks of persistent pulmonary hypertension in the newborn for each of the specific SSRIs (sertraline, citalopram, paroxetine, and fluoxetine) were of similar magnitude. Filling a prescription with SSRIs before gestational week 8 yielded slightly increased risks: adjusted odds ratio 1.4 (95% confidence interval 1.0 to 2.0).
  
  
  CONCLUSIONS
  The risk of persistent pulmonary hypertension of the newborn is low, but use of SSRIs in late pregnancy increases that risk more than twofold. The increased risk seems to be a class effect.
authors.affiliation: Centre for Pharmacoepidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, T2, SE-171 76 Stockholm, Sweden. helle.kieler@ki.se
authors.forename: Helle
authors.initials: H
authors.lastname: Kieler
authors.forename: Miia
authors.initials: M
authors.lastname: Artama
authors.forename: Anders
authors.initials: A
authors.lastname: Engeland
authors.forename: Orjan
authors.initials: O
authors.lastname: Ericsson
authors.forename: Kari
authors.initials: K
authors.lastname: Furu
authors.forename: Mika
authors.initials: M
authors.lastname: Gissler
authors.forename: Rikke Beck
authors.initials: RB
authors.lastname: Nielsen
authors.forename: Mette
authors.initials: M
authors.lastname: Nørgaard
authors.forename: Olof
authors.initials: O
authors.lastname: Stephansson
authors.forename: Unnur
authors.initials: U
authors.lastname: Valdimarsdottir
authors.forename: Helga
authors.initials: H
authors.lastname: Zoega
authors.forename: Bengt
authors.initials: B
authors.lastname: Haglund
mesh_terms: D000328:Adult; D003866:Depressive Disorder / Q000188:drug therapy*; D005260:Female; D005333:Fetus / Q000187:drug effects*; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D006976:Hypertension, Pulmonary / Q000139:chemically induced* / Q000453:epidemiology; D007055:Iceland / Q000453:epidemiology; D015994:Incidence; D007231:Infant, Newborn; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011446:Prospective Studies; D012307:Risk Factors; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors