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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, 2012-01, Vol.344 (7842), p.20-20 [Peer Reviewed Journal]

Kieler et al 2011 ;BMJ Publishing Group Ltd 2012 ;Copyright: 2011 © Kieler et al 2011 ;info:eu-repo/semantics/openAccess ;ISSN: 0959-8138 ;ISSN: 0959-8146 ;ISSN: 1756-1833 ;EISSN: 1468-5833 ;EISSN: 1756-1833 ;DOI: 10.1136/bmj.d8012 ;PMID: 22240235 ;CODEN: BMJOAE

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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
Author: Kieler, Helle ; Artama, Miia ; Engeland, Anders ; Ericsson, Örjan ; Furu, Kari ; Gissler, Mika ; Nielsen, Rikke Beck ; Nørgaard, Mette ; Stephansson, Olof ; Valdimarsdottir, Unnur ; Zoega, Helga ; Haglund, Bengt
Subjects: Adult ; Antidepressants ; Births ; Citalopram ; Clinical medical sciences: 750 ; Depressive Disorder - drug therapy ; Female ; Fetus - drug effects ; Finland - epidemiology ; Fluoxetine ; Follow-Up Studies ; Gynaecology and obstetrics: 756 ; Gynekologi og obstetrikk: 756 ; Health risk assessment ; Hospital admissions ; Humans ; Hypertension ; Hypertension, Pulmonary - chemically induced ; Hypertension, Pulmonary - epidemiology ; Iceland - epidemiology ; Incidence ; Infant, Newborn ; Infants ; Kardiovaskulær medisin / Cardiovascular medicine ; Klinisk medisinske fag: 750 ; Lungesykdommer / Lung Diseases ; Medicin och hälsovetenskap ; Medisinske fag: 700 ; Middle Aged ; Midical sciences: 700 ; Mor-barn helse / Mother-child health ; Mothers ; Newborn babies ; Newborns ; Nitric oxide ; Paroxetine ; Population studies ; Population Surveillance - methods ; Pregnancy ; Pregnancy Complications - drug therapy ; Prescription drugs ; Prospective Studies ; Psychiatric hospitals ; Public health ; Pulmonary hypertension ; Risk Factors ; Scandinavian and Nordic Countries - epidemiology ; Serotonin ; Serotonin agents ; Serotonin uptake inhibitors ; Serotonin Uptake Inhibitors - adverse effects ; Sertraline ; Spedbarn / Infant ; VDP ; Womens health ; Young Adult
Is Part Of: BMJ, 2012-01, Vol.344 (7842), p.20-20
Description: 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.Design Population based cohort study using data from the national health registers.Setting Denmark, Finland, Iceland, Norway, and Sweden, 1996-2007.Participants More than 1.6 million infants born after gestational week 33.Main outcome measures 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.
Publisher: England: British Medical Journal Publishing Group
Language: English
Identifier: ISSN: 0959-8138
ISSN: 0959-8146
ISSN: 1756-1833
EISSN: 1468-5833
EISSN: 1756-1833
DOI: 10.1136/bmj.d8012
PMID: 22240235
CODEN: BMJOAE
Source: BMJ Open Access Journals
MEDLINE
NORA Norwegian Open Research Archives
Alma/SFX Local Collection
SWEPUB Freely available online
ProQuest Central

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Selective serotonin reuptake inhibitors during pregnancy and risk of persistent pulmonary hypertension in the newborn: population based cohort study from the five Nordic countries

Kieler et al 2011 ;BMJ Publishing Group Ltd 2012 ;Copyright: 2011 © Kieler et al 2011 ;info:eu-repo/semantics/openAccess ;ISSN: 0959-8138 ;ISSN: 0959-8146 ;ISSN: 1756-1833 ;EISSN: 1468-5833 ;EISSN: 1756-1833 ;DOI: 10.1136/bmj.d8012 ;PMID: 22240235 ;CODEN: BMJOAE

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