Maternal Antidepressant Use and Risk of PPHN

Slides:

Advertisements

Similar presentations

Obstetric Emergencies

Advertisements

Meconium Happens: Meconium Aspiration Syndrome John Salyer RRT-NPS, FAARC, MBA Director Respiratory Therapy Seattle Children’s Hospital and Research Institute.

The ACOG Task force on hypertension in pregnancy

HUM-FL-1 Demonstrate employability skills required by business and industry.

Indiana Panel Presentation Region V Infant Mortality Summit, Chicago, IL March 21, 2013 Bob Bowman, MS, MA, MS Interim Maternal and Child Health Director.

The Forgotten Beneficiary of the Medicaid Expansions Andrea Kutinova and Karen Smith Conway Department of Economics University of New Hampshire.

Pharmacological Treatment of Opioid Dependence during Pregnancy: Methadone and Buprenorphine Overview Karol Kaltenbach, PhD Maternal Addiction Treatment.

Meconium Aspiration Syndrome Edited May  PO 2 L --> R ductus arteriosus shunt Ventilation Remove Placenta Ductus Venosus Closes  Systemic Vascular.

Guidance for Industry Establishing Pregnancy Registries Pregnancy Registry Working Group Pregnancy Labeling Taskforce March, 2000 Evelyn M. Rodriguez M.D.,

Respiratory Distress Syndrome

Thyroid Disease in Pregnancy Kevin Trueblood Research Review.

Prescribed and Non- prescribed Medication Use in Early Pregnancy in a Prospective Cohort of Women Brian J Cleary, Hajeera Butt, Judith Strawbridge, Paul.

Neonatal Group B Streptococcal Infections

Asthma and Pregnancy Michael Schatz, MD, MS Chief, Department of Allergy Kaiser-Permanente Medical Center San Diego, CA.

Use of ACE Inhibitors in Pregnant Women and the Risk of Congenital Heart Defects De-Kun Li, MD, PhD Division of Research Kaiser Permanente Northern California.

Fetal Origins of Disease Hypothesis Grace M. Egeland, Ph.D. University of Bergen.

Dental Care During Pregnancy Oregon 2000 Kathy R. Phipps, DrPH (1) Kenneth D. Rosenberg, MD, MPH (2) Alfredo P. Sandoval, MS, MBA (2) (1) Association of.

OBesity Project Pregnancy.

More Than 60 Published Studies In Medical Literature SMOKING & REPRODUCTION.

AETIOLOGY Case control studies (also RCT, cohort and ecological studies)

Maternal Alcohol Consumption and Risk of Orofacial Clefts Lixian Sun Department of Epidemiology.

SEVERE VITAMIN D DEFICIENCY AMONG NEWBORNS IN AMMAN, JORDAN Najwa Khuri-Bulos, MD, FIDSA,3, Ryan D. Lang, BS 1, Meridith Blevins, MS 2, Katherine Kudyba,

Periodontal Health and Birth Outcomes Secretary’s Advisory Committee on Infant Mortality – SACIM November 30, 2006 M. Ann Drum, DDS, MPH, Director Department.

Medical Disease in Pregnancy Cardiovascular Disease Cullen Archer, MD Department of Obstetrics and Gynecology.

Some Canadian data on infant mortality by socio-economic group Excerpted from “Socioeconomic inequality in health outcomes”, presentation by R. Wilkins,

Marion County Women’s Health Issues Virginia A. Caine, M.D. Director, Marion County Public Health Department Associate Professor, Indiana University School.

Mental Health in Pregnancy Baby blues Affects approx 50% of women post delivery Brief episode of misery.

Meconium Aspiration Syndrome

Maternal Child and Adolescent Health - Update CCDDPP Conference October 25, 2006 Cheryl H. Terpak, RDH, MS Oral Health Consultant - MCAH.

This presentation is intended for educational use only, and does not in any way constitute medical consultation or advice related to any specific patient.

Ethiopia Demographic and Health Survey 2011 Mortality.

Chris Burke, MD. What is the Ductus Arteriosus? Ductus Arteriosus  Allows blood from RV to bypass fetal lungs  Between the main PA (or proximal left.

Ultrasound Best practice antenatal care for a woman who has no complications of pregnancy, involves referral for two screening-based ultrasounds a first.

何積泓 Infertility The incidence of infertility is increasing The incidence of infertility is increasing 1.3~4.2% newborns in Europe result from.

Association Between Serotonergic Antidepressant Use During Pregnancy and Autism Spectrum Disorder in Children Hilary K. Brown, PhD; Joel G. Ray, MD, MSc,

UOG Journal Club: January 2017

Objective: To assess the prevalence of anemia in a sample of Jordanian pregnant women and to find out whether packed cell volume (PCV) affected by the.

The cardiovascular system

Antidepressant-Induced Sexual Dysfunction

Persistent Pulmonary Hypertension of the Newborn

Ziya Kalem,MD Gurgan Clinic IVF and Women Health Center

Mei-Yin Lai, Shih-Ming Chu, Satyan Lakshminrusimha, Hung-Chih Lin

AGOS Reproductive Health Report Card 2017

Maternal Factors and Risk of Late Preterm Delivery

Lessons on Malignancy.

Cardiopulmonary Interactions in PPHN

Nurses' Health Study: Risk of hypertension associated with >1000 µg/day of folate vs

Operationalizing Inclusion

Baseline and Serial Brain Natriuretic Peptide Level Predicts 5-Year Overall Survival in Patients With Pulmonary Arterial Hypertension: Data From the REVEAL.

Cepheid Symposium, IAS 23rd July 2018

Lucky Jain, MD, MBA Clinics in Perinatology

Prescribing SGAs During Pregnancy

Use of Mood Stabilizers and SGAs During Pregnancy

Risk of major congenital malformations among study infants according to fetal exposure to antihypertensives during first trimester alone* Variable ACE.

Relative risk reduction for incident hypertension associated with weight loss of 6.8 kg: The Framingham Study Cohort Risk reduction (%) Relative risk.

Etiology and pathophysiology of persistent pulmonary hypertension of the newborn (PPHN). Etiology and pathophysiology of persistent pulmonary hypertension.

Lower Hudson Valley Community Health Dashboard: Maternal and Infant Health in Westchester, Rockland, and Orange counties Last Updated: 3/20/2019.

Inclusion characteristics of a) previously diagnosed and b) newly diagnosed pulmonary arterial hypertension (PAH) patients enrolled in REVEAL. PVR: pulmonary.

Anthropometric parameters

Echocardiographic evaluation of neonatal hypoxemia based on ductal (black bar) and atrial (blue bar) shunts. Echocardiographic evaluation of neonatal hypoxemia.

Serum Vitamin C (mg/dl) by Salad Intake

Algorithm showing practical approach to persistent pulmonary hypertension of the newborn (PPHN) based on oxygenation, systemic blood pressure, and cardiac.

Maternal Psychological Distress and Cortisol

Echocardiographic features of persistent pulmonary hypertension of the newborn (PPHN): high right ventricular pressure results in tricuspid regurgitation.

A) Pulmonary arterial hypertension (PAH) aetiological breakdown of REVEAL patients at enrolment. b) Breakdown of associated PAH subgroup. a) Pulmonary.

Representative echocardiographic findings: women with HDP versus women with NCP. †P

Copyright Notice This presentation is copyrighted by the Psychopharmacology Institute. Subscribers can download it and use it for professional use. The.

Copyright Notice This presentation is copyrighted by the Psychopharmacology Institute. Subscribers can download it and use it for professional use. The.

Copyright Notice This presentation is copyrighted by the Psychopharmacology Institute. Subscribers can download it and use it for professional use. The.

Presentation transcript:

Maternal Antidepressant Use and Risk of PPHN Flavio Guzmán, MD

About PPHN Elevated pulmonary vascular resistance Birth Vascular resistance drops Birth Elevated pulmonary vascular resistance Nair, J., & Lakshminrusimha, S. (2014, March). Update on PPHN: mechanisms and treatment. InSeminars in perinatology (Vol. 38, No. 2, pp. 78-91). WB Saunders.

About PPHN Elevated pulmonary vascular resistance Severe hypoxemia Right-to-left shunting of blood through fetal circulatory pathways Elevated pulmonary vascular resistance Nair, J., & Lakshminrusimha, S. (2014, March). Update on PPHN: mechanisms and treatment. InSeminars in perinatology (Vol. 38, No. 2, pp. 78-91). WB Saunders.

Background

2006 FDA: SSRIs late in pregnancy might increase the risk of PPHN Study: sixfold increase in PPHN when mother took an SSRI More studies: 2 positive 3 negative 2011 FDA: Uncertainty

2006 FDA: SSRIs late in pregnancy might increase the risk of PPHN Study: sixfold increase in PPHN when mother took an SSRI More studies: 2 positive 3 negative 2011 FDA: Uncertainty

2006 FDA: SSRIs late in pregnancy might increase the risk of PPHN Study: sixfold increase in PPHN when mother took an SSRI More studies: 2 positive 3 negative 2011 FDA: Uncertainty

Type: cohort study The Huybrechts study Data from pregnant women and infants enrolled in Medicaid Included a total of 3,789,330 women Huybrechts, K. et al (2015). Antidepressant use late in pregnancy and risk of persistent pulmonary hypertension of the newborn. JAMA, 313(21), 2142-2151.

Type: cohort study The Huybrechts study 3.4 % used antidepressants Huybrechts, K. et al (2015). Antidepressant use late in pregnancy and risk of persistent pulmonary hypertension of the newborn. JAMA, 313(21), 2142-2151.

Type: cohort study The Huybrechts study 2.7 % SSRIs 3.4 % used antidepressants 0.7 % Non-SSRIs Huybrechts, K. et al (2015). Antidepressant use late in pregnancy and risk of persistent pulmonary hypertension of the newborn. JAMA, 313(21), 2142-2151.

Incidence of PPHN Unexposed: 21/10,000 SSRIs: 32/10,000 Non-SSRIs: 29/10,000 Huybrechts, K. et al (2015). Antidepressant use late in pregnancy and risk of persistent pulmonary hypertension of the newborn. JAMA, 313(21), 2142-2151.

Odds Ratio 6.1 1.28 Huybrechts, K. et al (2015). Antidepressant use late in pregnancy and risk of persistent pulmonary hypertension of the newborn. JAMA, 313(21), 2142-2151.

Summary There is a potential risk of PPHN associated with maternal use of SSRIs in late pregnancy The overall risk might be more modest than previously described