An investigation published on bmj.com reveals that children are more likely to be born with persistent pulmonary hypertension (high blood pressure in the lungs) if the mother took anti-depressants during pregnancy.

Persistent pulmonary hypertension is a rare, but severe disease associated to heart failure. The disease increases blood pressure in the lungs causing:

  • shortness of breath
  • dizziness
  • fainting
  • and difficulty breathing

Investigators at the Centre for Pharmacoepidemiology at Karolinska Institutet in Stockholm Sweden, examined a total of 1.6 million births between 1996 and 2009 in Sweden, Finland, Denmark, Norway and Iceland. The infants were examined at 33 weeks.

In the study a total of 1,618,255 singleton births were included. In early pregnancy around 17,000 of the mothers filled out a prescription for anti-depressants and approximately 11,000 in late pregnancy.

The researchers found that those who filled out a prescription were primarily older mothers who smoked. In addition, 54,184 mothers not taking any medication were identified as having previously undergone psychiatric diagnosis.

During the investigation the researchers took into account factors, such as year of birth, birth weight, gestational age at birth, persistent pulmonary hypertension, maternal smoking, BMI (in early pregnancy), and maternal diseases including arthritis, lupus, pre-eclampsia, malignancies, and bowel disease.

The researchers examined several drugs mothers used, including fluvoxamine, fluoxetine, paroxetine, sertraline, citalopram, escitalopram, and fluvoxamine. They discovered that fluvoxamine was rarely used and none of the children with persistent pulmonary hypertension were exposed to this drug.

The team discovered that just 33 babies (0.2%) out of 11,014 mothers who used anti-depressants in late pregnancy were born with persistent pulmonary hypertension. In addition only 32 babies (less than 0.2%) out of the 17,053 mothers who used anti-depressants during early pregnancy were diagnosed with the disease, while a total of 114 babies whose mothers had previously been diagnosed with a mental illness had persistent pulmonary hypertension.

For babies of women using anti-depressant during pregnancy, being small for gestational age, or being born by C-section did not influence the chances of having the disease.

Although the risk of developing the disease is low (approximately 3 per 100 women which more than doubles if anti-depressants are taken in late pregnancy), the researchers advise caution when treating pregnant women with anti-depressants.

In an associated report, investigators from the Motherisk Program Hospital for Sick Children in Toronto and the School of Pharmacy at the University of Oslo agree that pregnant women taking anti-depressants in late pregnancy have a higher chance of giving birth to children with the disease.

Written by Grace Rattue