Selective serotonin reuptake inhibitors (SSRIs) are used as antidepressants. Drugs included in the SSRI class are Prozac, Zoloft, Paxil, Symbyax, Celexa, Cymbalta, Effexor and Lexapro. However, some studies, including one published in the
New England Journal of Medicine have linked SSRIs to serious birth defects, including persistent pulmonary hypertension of the newborn (PPHN).
The study found that women who took SSRIs during their third trimester were six times more likely to deliver babies born with PPHN—or to have babies that would develop primary pulmonary hypertension—than women who did not take SSRIs during their third trimester.
PPH is a disorder of the lungs in which the arteries are severely restricted, causing the blood pressure in the pulmonary artery of the heart to rise to excessive levels. Blood flow is restricted and oxygen levels in the blood are suppressed.
While in the womb, the baby's circulation is handled by the placenta, and does not go through the lungs. After birth, the baby's circulation switches over from the ductus arteriosus (which now closes) to the lungs.
However, in a baby born with PPHN, the ductus arteriosus stays open and the baby's blood flow continues to bypass the lungs. Since the blood does not enter the lungs, it returns to the heart very low in oxygen.
The baby's organs, such as the brain, kidneys and liver quickly become stressed due to lack of oxygen. PPHN is usually diagnosed within 12 hours of delivery.
PPHN Symptoms
These symptoms may indicate PPHN:
- Rapid Breathing
- Rapid Heart Rate
- Difficulty Breathing
- Bluish Skin
- Heart Murmurs
- Low Blood Oxygen Levels
SSRI Info
Diagnosing PPHN
A chest x-ray or ultrasound may help to diagnose whether or not a baby has PPHN. Doctors may order lab tests such as Arterial Blood Gas (ABG), Complete Blood Count (CBC), serum electrolyte tests, pulse oximetry or may do a spinal tap.
Babies diagnosed with PPHN usually need to be cared for in a neonatal intensive care unit (NICU). Pure oxygen will be given to the baby through a tube inserted into the windpipe. An extracorporeal membrane oxygenation machine (ECMO) may be used to act as an artificial heart and lung while the baby's lungs recover.
PPHN is a very serious birth defect, and even with treatment the PPHN baby may experience shock, heart failure, brain hemorrhage, seizures, kidney failure, organ damage and even death. Babies who survive PPHN may have long-term breathing difficulties, seizures, developmental disorders and hearing loss.
Another study showed that mothers who took antidepressants during pregnancy gave birth to babies who experienced withdrawal symptoms such as seizures, tremors, gastrointestinal problems and sleep disturbances. There is controversy over the safety of these drugs since the long term effects on the baby are still unknown.
New York, NY: Another study has been published suggesting a potential for SSRI birth defects in children exposed to selective serotonin reuptake inhibitors (SSRIs) prior to birth. The study found that babies whose mothers used the antidepressants while pregnant were at greater risk of developing congenital heart defects and other SSRI side effects. [ 
Philadelphia, PA: The tragedy of SSRI birth defects was brought home last week when a jury in Philadelphia found for the plaintiff and held the manufacturer of an SSRI antidepressant responsible for the formation of heart defects in an unborn child. Given the growing concern over SSRI side effects, and the fact that selective serotonin reuptake inhibitors have become the most commonly prescribed class of antidepressants, doctors are continuing to face a dilemma with increasing frequency. [ 
Tulsa, OK: A new study suggests that women who take selective serotonin reuptake inhibitors (SSRIs) during pregnancy are at a greater risk for having children born with birth defects. Although the study did not include the risk of persistent pulmonary hypertension of the newborn (PPHN), it did find an increase in another heart-related birth defect, known as a septal heart defect. Again, mothers are left to determine if the risk of SSRI side effects, including SSRI birth defects, is worth the benefit that taking SSRIs may provide. [ 
