Increased Rates of PPHN Birth Injury Linked to Some Medications


Persistent pulmonary hypertension of the newborn (PPHN) is a birth defect defined as the failure of the normal circulatory transition occurring after birth. The syndrome is characterized by pulmonary hypertension that causes hypoxemia. Infant survivors of PPHN birth injury are at risk of serious developmental disabilities—long-term cognitive problems such as a learning disability, autism, or ADHD.

PPHN affects normal breathing, which presents obvious risks. The longer an infant is deprived of oxygen, the more hypoxic the baby’s blood becomes. Oxygen deprivation can cause the victim’s brain to react adversely, leading to death or severe injuries.

Joe Lyon is a highly-rated Ohio attorney representing plaintiffs nationwide in a wide variety of civil litigation claims against pharmaceutical companies, and medical professionals responsible for children born with injuries. 


SSRI Drugs & Other Risk Factors


PPHN, or persistent fetal circulation syndrome, usually occurs in full-term babies or babies who were born at 34 weeks or more. These babies often have other types of breathing conditions.

During pregnancy, babies get oxygen from their mother and the placenta. PPHN occurs when the blood vessels do not open up enough, and there is a limit on how much oxygen is sent to the brain and organs. There is a suspected increased risk of PPHN birth injury if the mother is taking selective serotonin reuptake inhibitors (SSRIs) during the last trimester of pregnancy.

Untreated depression in pregnant women can pose serious risks, though the alternative of taking selective serotonin reuptake inhibitors (SSRIs) may increase the risk of PPHN and other birth defects of the heart and abdominal cavity.

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A report in a 2006 edition of the New England Journal of Medicine describes a link between the maternal use of SSRIs (including Paxil) and PPHN. The U.S. Food and Drug Administration (FDA) revised its warnings on SSRI drugs accordingly. Other factors that may increase the infant’s risk of developing PPHN include:

  • Meconium aspiration—this happens when the baby breathes in its own meconium
  • Infection
  • Respiratory distress syndrome (RDS)—this breathing difficulty happens in infants who do not have fully developed lungs
  • Lack of oxygen before or during birth

Common Symptoms of PPHN


Symptoms of PPHN may include the following:

  • Rapid or slow breathing, grunting, and retracting
  • Bluish color to the skin
  • Hands and feet cool to the touch
  • Low blood pressure throughout the body
  • Low blood oxygen levels
  • Asphyxia
  • Tachypnea, respiratory distress
  • Respiratory acidosis
  • Loud, single second heart sound or a harsh systolic murmur
  • Low Apgar scores
  • Meconium staining
  • Poor cardiac function and perfusion
  • Systemic hypotension
  • Symptoms of shock
  • Acute perinatal distress

Treatment & Management of PPHN


PPHN is most often recognized in term or near-term neonates, but it can occur in premature newborns. In contrast to adult primary pulmonary hypertension, the newborn condition is not defined by a specific pressure of the pulmonary circulation. The diagnosis is confirmed regardless of the pulmonary arterial pressure, as long as it is accompanied by a right-to-left shunt and absence of congenital heart disease.

The treatment strategy for PPHN is aimed at maintaining adequate systemic blood pressure, decreasing pulmonary vascular resistance, ensuring oxygen release to tissues, and minimizing lesions induced by high levels of inspired oxygen and ventilator high pressure settings. General management principles include the following:

  • Continuous monitoring of oxygenation, blood pressure, and perfusion
  • Maintaining a normal body temperature
  • Correction of electrolytes and glucose abnormalities and metabolic acidosis
  • Nutritional support
  • Minimal stimulation and handling of the newborn
  • Minimal use of invasive procedures
  • Medical therapy

Compensation Following PPHN Birth Injury


Birth defects take a significant toll on the health industry and on families across the country. The out-of-pocket medical costs for an infant with any birth defect can be enormous and families can be faced with huge lifestyle changes, lost wages, and long-term personal care costs for disabled children.

If your child has suffered PPHN that may be linked to the use of a prescribed drug, you may seek compensation and may have a rightful claim against the drug makers or healthcare professionals responsible. The Lyon Firm is committed to recovering medical costs and proper compensation for the suffering and emotional pain that comes from birth defects and birth injuries.


If your child was born with PPHN due to the use of pharmaceuticals or medical malpractice, and have questions about the legal remedies available to improve quality of life and medical care, contact The Lyon Firm at (800) 513-2403. You will speak directly with Mr. Lyon, and he will help you answer critical questions about PPHN birth injury.