title: SSRI and SNRI use during pregnancy and the risk of persistent pulmonary hypertension of the newborn.
abstract: The use of selective serotonin reuptake inhibitors (SSRIs) in late pregnancy may be associated with an increased risk of persistent pulmonary hypertension of the newborn (PPHN). Limited data are available on the risk of PPHN associated with serotonin norepinephrine reuptake inhibitors (SNRIs). We aimed to quantify both associations.
  
  
  
  Using data from the Quebec Pregnancy Cohort between 1998 and 2009, we included women covered by the provincial drug plan who had a singleton live birth. Exposure categories were SSRI, SNRI and other antidepressant use; non-users were considered as the reference category. Generalized estimating equation models were used to obtain risk estimates and 95% confidence intervals (CIs). Confounding by indication was minimized by adjusting for history of maternal depression/anxiety before pregnancy.
  
  
  
  Overall, 143 281 pregnancies were included; PPHN was identified in 0.2% of newborns. Adjusting for maternal depression, and other potential confounders, SSRI use during the second half of pregnancy was associated with an increased risk of PPHN [adjusted odds ratio (aOR) 4.29, 95% CI 1.34, 13.77] compared with non-use of antidepressants; SNRI use during the same time window was not statistically associated with the risk of PPHN (aOR 0.59, 95% CI 0.06, 5.62). Use of SSRIs and SNRIs before the 20th week of gestation was not associated with the risk of PPHN.
  
  
  
  Use of SSRIs in the second half of pregnancy was associated with the risk of PPHN. Given our results on SNRIs and the lack of statistical power for these analyses, it is unclear whether SNRI use during pregnancy also increases the risk of PPHN.
authors.affiliation: Research Center, CHU Sainte-Justine, Montreal, Quebec, Canada.|Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Anick
authors.initials: A
authors.lastname: Bérard
authors.affiliation: Research Center, CHU Sainte-Justine, Montreal, Quebec, Canada.
authors.forename: Odile
authors.initials: O
authors.lastname: Sheehy
authors.affiliation: Research Center, CHU Sainte-Justine, Montreal, Quebec, Canada.|Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Jin-Ping
authors.initials: JP
authors.lastname: Zhao
authors.affiliation: Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
authors.forename: Évelyne
authors.initials: É
authors.lastname: Vinet
authors.affiliation: Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
authors.forename: Sasha
authors.initials: S
authors.lastname: Bernatsky
authors.affiliation: Faculty of Medicine, Department of Clinical Epidemiology, McGill University, Montreal, Quebec, Canada.
authors.forename: Michal
authors.initials: M
authors.lastname: Abrahamowicz
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010547:Persistent Fetal Circulation Syndrome / Q000139:chemically induced* / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy; D011264:Pregnancy Trimesters; D011792:Quebec; D012042:Registries; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D000068760:Serotonin and Noradrenaline Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors; D000068760:Serotonin and Noradrenaline Reuptake Inhibitors
keywords: Pregnancy; SSRI; depression; persistent pulmonary hypertension of the newborn (PPHN); quebec pregnancy cohort; venlafaxine