Re: Selective serotonin reuptake inhibitors during pregnancy and risk of persistent pulmonary hypertension in the newborn: population based cohort study from the five Nordic countries
Intrauterine Stress to the baby due to maternal complications (such as: diabetes, hypertension, anaemia etc.) or baby per se (hypoglycemia, birth asphyxia, meconium aspiration syndrome, late preterm and postterm etc.) will cause Persistent Pulmonary hypertension of Newborn (PPHN). This occurs because of the failure of the normal fetal-to-neonatal circulatory transition, and is associated with substantial infant mortality and morbidity1.
Findings of a large case-control study (377 mothers of infants with persistent pulmonary hypertension of the newborn and 836 mothers of matched control subjects) carried out in USA, suggest an increased risk for persistent pulmonary hypertension of the newborn associated with cesarean delivery; late preterm or postterm birth; being large for gestational age; and maternal black or Asian race, overweight, diabetes, and asthma1. In this study, compared with infants who were born within 37 to 41 gestational weeks, the risk was higher for those who were born between 34 and 37 completed weeks and for those born beyond 41 weeks1. Since the present study is with the objective to determine the effect of SSRI intake on causation of PPHN, the confounding of late preterm (33 weeks to 37 weeks) should have been adjusted before interpreting the results and the incidence of PPHN should have been determined in these late preterm babies, though the study has taken care of other confounders.
1. Hernández-Díaz S, Van Marter LJ, Werler MM, Louik C, Mitchell AA. Risk factors for persistent pulmonary hypertension of the newborn. Pediatrics. 2007 Aug;120(2):e272-82.
Competing interests: No competing interests