The initial warning of the FDA was not to prescribe Paxil to women who are in the first three months of pregnancy or are planning pregnancy, unless other treatment options are not appropriate. www.fda.gov/cder/drug/advisory/paroxetine200512.htm However, the New England Journal of Medicine (Feb 9, 2006), based on a retrospective case-control study, found that taking antidepressants, including Paxil, after 20 weeks of pregnancy, i.e., in the second trimester of pregnancy, increases the risk of the baby being born with Persistent Pulmonary Hypertension (PPHN). PPHN is a potentially fatal lung condition that occurs shortly after birth. Babies with PPHN are not able to get enough oxygen in their bloodstream because of high pressure in their lung blood vessels.

More specifically, according to the authors of this study, the risk of PPHN is six times greater in women who take an SSRI antidepressant after the 20th week pregnancy. In women who do not take SSRIs, the rate of PPHN is one or two per 1000 live births. A statement on the FDA's website states, "Neonatal PPHN is associated with significant morbidity and mortality." This concern about PPHN is in addition to previous reports that late-term exposure to SSRIs can result in withdrawal symptoms such as irritability, difficulty feeding, and difficulty breathing for the mothers of the infants.

We recommend seeking additional information about the possible risk of PPHN in newborn babies of mothers who took SSRI antidepressants in pregnancy.