Current data suggests that disorders associated with PPHN have an overall mortality rate of 10-20%, although ACD/MPV is uniformly lethal despite the use of inhaled nitric oxide therapy often combined with extracorporeal membrane oxygenation [11,26].
After the data were adjusted to account for the substantial differences between women who used antidepressants and women who did not, the adjusted odds ratio for having a neonate with PPHN was 1.10 for women who used SSRIs and 1.02 for those who used non-SSRIs, compared with nonusers.
It was found that male sex (88.8%), cesarean-section delivery (77.7%), respiratory distress syndrome (RDS) 44.8% and sepsis (44.4%) were more associated with PPHN in premature infants than with term and post term infants.
2006: In a warning about the risk of persistent pulmonary hypertension (PPHN) with antidepressant use during pregnancy, the FDA acknowledged "decisions about how to treat depression in pregnant women are increasingly complex." (2) The FDA issued the warning based on a study by Chambers et al.
Similar to nitric oxide (NO), when used by the inhaled route it selectively dilates pulmonary vessels and improves oxygenation.3 A few case reports have demonstrated the effectiveness and safety of inhaled iloprost in preterm infants, including extremely preterm ones and term infants with persistent pulmonary hypertension (PPHN) refractory to inhaled NO (iNO).3-8 Currently the use of inhaled iloprost has not been approved for premature neonates, and its therapeutic efficacy in this group remains controversial.
That earlier warning was based on a single study indicating that infants exposed to the drug in utero after the 20th week of pregnancy were six times more likely to develop persistent pulmonary hypertension (PPHN) than nonexposed infants (N.