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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

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 d...

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Autores principales: Buffoni, Isabella, Buratti, Silvia, Mallamaci, Marisa F., Pezzato, Stefano, Lampugnani, Elisabetta, Buffelli, Francesca, Fulcheri, Ezio, Moscatelli, Andrea
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9227662/
https://www.ncbi.nlm.nih.gov/pubmed/35757139
http://dx.doi.org/10.3389/fped.2022.855419
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author Buffoni, Isabella
Buratti, Silvia
Mallamaci, Marisa F.
Pezzato, Stefano
Lampugnani, Elisabetta
Buffelli, Francesca
Fulcheri, Ezio
Moscatelli, Andrea
author_facet Buffoni, Isabella
Buratti, Silvia
Mallamaci, Marisa F.
Pezzato, Stefano
Lampugnani, Elisabetta
Buffelli, Francesca
Fulcheri, Ezio
Moscatelli, Andrea
author_sort Buffoni, Isabella
collection PubMed
description 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.
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spelling pubmed-92276622022-06-25 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 Buffoni, Isabella Buratti, Silvia Mallamaci, Marisa F. Pezzato, Stefano Lampugnani, Elisabetta Buffelli, Francesca Fulcheri, Ezio Moscatelli, Andrea Front Pediatr Pediatrics 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. Frontiers Media S.A. 2022-06-10 /pmc/articles/PMC9227662/ /pubmed/35757139 http://dx.doi.org/10.3389/fped.2022.855419 Text en Copyright © 2022 Buffoni, Buratti, Mallamaci, Pezzato, Lampugnani, Buffelli, Fulcheri and Moscatelli. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Buffoni, Isabella
Buratti, Silvia
Mallamaci, Marisa F.
Pezzato, Stefano
Lampugnani, Elisabetta
Buffelli, Francesca
Fulcheri, Ezio
Moscatelli, Andrea
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
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9227662/
https://www.ncbi.nlm.nih.gov/pubmed/35757139
http://dx.doi.org/10.3389/fped.2022.855419
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