Sudden Onset of Severe Pulmonary Hypertension in a Preterm Infant: A Case Report on the Role of Maternal Use of Serotonin Re-Uptake Inhibitors During Pregnancy and Concurrent Risk Factors

Frontiers in Pediatrics

article

Isabella Buffoni¹  Silvia Buratti¹  Marisa F. Mallamaci¹  Stefano Pezzato¹  Elisabetta Lampugnani¹  Francesca Buffelli²  Ezio Fulcheri²  Andrea Moscatelli¹ 

[1] Division of Neonatal and Pediatric Intensive Care, Emergency Department, IRCCS Giannina Gaslini Institute;Fetal and Perinatal Pathology Unit, IRCCS Giannina Gaslini Institute;Department of Surgical Sciences and Integrated Diagnostics, University of Genoa

关键词: pulmonary hypertension;    preterm;    newborn;    selective serotonin reuptake inhibitors;    case report;    fetal growth restriction;   

DOI  :  10.3389/fped.2022.855419

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Persistent pulmonary hypertension of the newborn (PPHN) is a severe condition caused by failed circulatory adaptation at birth. Pulmonary hypertension is most common in full-term infants and rare in preterms, although it is increasingly diagnosed also in extremely preterm infants. Previous studies demonstrated the association between maternal use of selective serotonin re-uptake inhibitors during gestation and pulmonary hypertension. This brief report describes the complex physiopathological correlations that were identified in a case of severe pulmonary hypertension in a fetal growth restricted (FGR) preterm infant, with a history of maternal use of antidepressants during pregnancy. Perinatal factors, triggers and aggravating mechanisms caused a dramatic clinical course. Maternal history of escitalopram therapy throughout pregnancy was noted. Uteroplacental insufficiency, fetal hypoxia, FGR, preeclampsia, preterm delivery, antenatal steroids, and cesarean section were documented as concurrent risk factors. Myocardial immaturity and dysfunction, secondary to FGR and prematurity aggravated the hemodynamic compromise. The short time gap between pharmacological ductal closure and the onset of PPHN may suggest a cause–effect relationship, as observed in previous reports. Placental histopathologic findings are reported.

【 授权许可】

CC BY