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Birth Injury Resource Center

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If your child suffers from cerebral palsy, Erb's palsy, PPHN or any other birth related injury, please fill out this form or call us at 1-800-682-9443 for a free case evaluation.

PPHN Causes and Risks

Persistent pulmonary hypertension in newborns (PPHN) is a relatively rare disorder, affecting approximately one to two babies in 1,000. Although the cause of PPHN is often unknown, research in the past 15 years has led to a better understanding of PPHN risk factors. It has also paved the way to improved treatments and a more promising outlook for children with PPHN.

PPHN and SSRIs

Recent research has focused on a link between selective serotonin reuptake inhibitors (SSRIs) and PPHN. SSRIs are a class of antidepressants commonly known by such brand names as Celexa, Lexapro, Paxil, Prozac and Zoloft. A 1996 study suggested that maternal use of Prozac during pregnancy may increase the risk for breathing problems, including PPHN, in newborns.

A follow-up to that study in 2006 led the Food & Drug Administration (FDA) to issue an advisory to health care professionals regarding the use of SSRIs by pregnant women. The research, published in the New England Journal of Medicine, concluded that mothers who took SSRIs in the second half of pregnancy were six times more likely to deliver an infant with PPHN than those who did not take antidepressants–or who discontinued their use in the first half of pregnancy.

While experts stop short of naming SSRI use as a cause of PPHN pending further study, the evidence surrounding the link is difficult to ignore.

Additional Risk Factors

In addition to the SSRI link, the following factors have been associated with an increased risk of PPHN.

  • Meconium aspiration syndrome. When the baby passes its first stool (meconium) into the amniotic fluid, there is a danger that the baby will inhale some of the meconium. Aspiration of meconium increases the risk of respiratory distress and PPHN.

  • Birth asphyxia. When complications during delivery cause the baby to receive inadequate oxygen, PPHN may result.

  • Diaphragm hernia. When the baby's diaphragm is herniated, the intestines can push into the chest cavity, impeding normal lung development and raising the risk of PPHN.

  • Low levels of nitric oxide. Nitric oxide is a natural compound that lowers blood pressure. Researchers have determined that low levels of nitric oxide may predispose an infant to PPHN.

  • Stress due to complications of pregnancy–such as post-term delivery or maternal diabetes, high blood pressure or anemia–has been found to increase the risk of PPHN.

  • A mother's use of nonsteroidal anti-inflammatory drugs (NSAIDs) during pregnancy has been shown to increase the risk of PPHN. Although current warning labels caution pregnant women against the use of NSAIDs, some medical experts have called for stronger, more explicit warnings, similar to those found on alcohol and tobacco products. NSAIDS include aspirin and such brand-name medications as Advil, Aleve and Motrin.

  • Any disease or congenital condition that affects the infant's respiratory or circulatory systems may increase the risk of PPHN.

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