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Comment & Response
September 22/29, 2015

Maternal Antidepressant Use and Persistent Pulmonary Hypertension of the Newborn—Reply

Author Affiliations
  • 1Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
  • 2Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston
  • 3Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
JAMA. 2015;314(12):1294. doi:10.1001/jama.2015.10048

In Reply Dr Giannakopoulos raises a valid point that there is uncertainty regarding how cesarean delivery should be incorporated into an analysis of the association between antidepressant medication use late in pregnancy and the risk of PPHN. Multiple roles for cesarean delivery in this analysis are possible: (1) cesarean delivery functions as an intermediate variable on the causal pathway between the exposure and the outcome or (2) cesarean delivery functions as a confounder by sharing a common cause with antidepressant medication use.

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