Persistent pulmonary hypertension of the neonate

Persistent pulmonary hypertension of the neonate (PPHN) is a rare condition affecting 1 to 2 infants per 1000 live births. It has a high rate of mortality (5%) and severe morbidity (60%). Although fetal exposure to an SSRI after 20 weeks gestation is associated with a small increase in absolute risk of this syndrome, the risk is still extremely low and does not preclude the use of SSRIs in pregnancy. The association does not appear to apply to other antidepressants, though these have been used in much smaller numbers than SSRIs, making it less likely that an association with such a rare disorder would be detectable. Advise the patient of this small increase in risk as part of the treatment decision-making process—see Principles of psychotropic use during pregnancy and Considerations for antidepressant use in pregnancy.