RESEARCH - Antidepressants may affect fetus

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Antidepressants may affect fetus

Medical Studies/Trials

Published: Monday, 20-Feb-2006

A University of California, San Diego (UCSD) School of Medicine

collaborative study with Boston University's Slone Epidemiology Center found

an increased risk of persistent pulmonary hypertension (PPHN) in newborns of

mothers who used certain commonly prescribed antidepressants in late

pregnancy.

The results of the study are published in the New England

Journal of Medicine.

According to the study authors, PPHN is a serious condition that

typically involves severe respiratory failure in a newborn infant and

requires immediate treatment. The condition occurs in about one to two per

thousand babies. The new study findings indicate that pregnant women who

take one of the antidepressants known as selective serotonin reuptake

inhibitors or SSRIs, such as Prozac., Paxil. or Zoloft., in the second half

of pregnancy have a small but significantly increased chance of delivering

an infant who develops PPHN. The study found that exposure to

antidepressants other than SSRIs did not pose a risk for PPHN. In addition,

women who discontinued use of SSRIs in the first half of pregnancy did not

have an increased risk of delivering a child with the condition.

These findings may be important for pregnant women and

clinicians when making decisions about the most appropriate treatments for

depression late in pregnancy.

Lead author on the study, Chambers, Ph.D., M.P.H., of

the Departments of Pediatrics and Family and Preventive Medicine at UCSD,

worked with a team of investigators who identified at birth 377 infants with

PPHN and 836 normal newborns from 97 delivery hospitals in four metropolitan

centers in the U.S. and Canada between 1998 and 2003. The study was part of

the ongoing Birth Defects Surveillance Program being conducted by the Slone

Epidemiology Center with the collaboration of 17 San Diego County hospitals

including UCSD Medical Center.

Within six months after birth, the researchers examined the

records and carefully interviewed the mothers of children with PPHN and the

mothers of the matched control infants selected from the same hospitals. The

mothers in both groups were asked specifically about the use of any

antidepressant medications during pregnancy, the names of products used, and

the timing in gestation when the mother used the medication. Mothers were

also queried about a wide variety of other maternal exposures, medical

history, pregnancy history, and lifestyle factors.

" Based on our findings, we estimate that six to twelve mothers

per thousand who use an SSRI after 20 weeks' gestation, are likely to

deliver a child with PPHN, " said Chambers. " Put in practical terms, the risk

is relatively low -- about 99 percent of women exposed to one of these

medications during the latter half of pregnancy will deliver an infant

unaffected by PPHN. "

" Our findings suggest that prenatal exposure to SSRIs might

contribute to the pathological origin of this disorder, " says Chambers. She

adds that although the study cannot establish cause, several possible

mechanisms suggesting an association between the use of the SSRIs and PPHN

are plausible.

Although the researchers noted an increased risk of PPHN in

infants whose mothers took SSRIs late in pregnancy, the research team points

out that mothers may need to continue SSRI treatment during pregnancy in

order to care for themselves appropriately. The findings of this study might

be factored into decisions about continuing treatment with SSRIs into late

pregnancy.

The research team consisted of Chambers, -,

M.D. Dr.P.H of Slone Epidemiology Center at Boston University School of

Public Health, J. Van Marter, M.D., Ph.D of Boston Children's

Hospital, Brigham and Women's Hospital, and Harvard Medical School, Martha

M. Werler, Sc.D, and A. , M.D. of Slone Epidemiology Center,

and Lyons , M.D. of the UCSD Department of Pediatrics.

Chambers is Program Director of the California Teratogen

Information Service (CTIS). CTIS operates a statewide telephone service and

a clinical research program from the Department of Pediatrics at UCSD with

satellite offices at UCLA, Los Angeles Children's Hospital and Stanford

University. Founded in 1979, this program provides no-cost, confidential

information regarding the fetal safety of medications, chemicals, or other

agents when used in pregnancy. The CTIS Pregnancy Risk Information line

provides information to over 8,000 callers per year including pregnant or

pre-pregnant women and health care providers located throughout the state of

California. The CTIS program also conducts pregnancy outcome research

studies so that evidence-based information can be developed for women with

similar questions in the future.

Pregnant women and health care providers can reach CTIS

specialists by calling toll free at 800-532-3749 or by contacting CTIS

through their website at http://www.ctispregnancy.org For people outside of

California, information on exposures in pregnancy can be obtained by calling

the Organization of Teratology Information Specialists (OTIS) national

toll-free number 866-626-6847 or visiting the OTIS website at

http://www.otispregnancy.org

http://www.ucsd.edu

http://www.news-medical.net/?id=16078

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org