Pregnancy outcomes following use of escitalopram: a prospective comparative cohort study

J Clin Pharmacol. 2012 May;52(5):766-70. doi: 10.1177/0091270011405524. Epub 2011 Nov 10.

Abstract

Escitalopram is a serotonin reuptake inhibitor prescribed for depression and anxiety. There is a paucity of information regarding safety in pregnancy. The objective of this study was to determine whether escitalopram is associated with an increased risk for major malformations or other adverse outcomes following use in pregnancy. The authors analyzed pregnancy outcomes in women exposed to escitalopram (n = 212) versus other antidepressants (n = 212) versus nonteratogenic exposures (n = 212) and compared the outcomes. Among the escitalopram exposures were 172 (81%) live births, 32 (15%) spontaneous abortions, 6 (2.8%) therapeutic abortions, 3 stillbirths (1.7%), and 3 major malformations (1.7%). The only significant differences among groups was the rate of low birth weight (<2500 g) and overall mean birth weight (P = .225). However, spontaneous abortion rates were higher in both antidepressant groups (15% and 16%) compared with controls (8.5%; P = .066). There were lower rates of live births (P = .006), lower overall birth weight (P < .001), and increased rates of low birth weight (<2500 g; P = .009) with escitalopram. Spontaneous abortion rates were nearly double in both antidepressant groups (15% and 16%) compared with controls (8.5%) but not significant (P = .066). Escitalopram does not appear to be associated with an increased risk for major malformations but appears to increase the risk for low birth weight, which was correlated with the increase in infants weighing <2500 g. In addition, the higher rates of spontaneous abortions in both antidepressant groups confirmed previous findings.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abnormalities, Drug-Induced / etiology
  • Abortion, Spontaneous / chemically induced
  • Abortion, Therapeutic
  • Analysis of Variance
  • Antidepressive Agents, Second-Generation / adverse effects*
  • Birth Weight / drug effects
  • Case-Control Studies
  • Chi-Square Distribution
  • Citalopram / adverse effects*
  • Female
  • Humans
  • Infant, Low Birth Weight
  • Infant, Newborn
  • Intensive Care Units, Neonatal
  • Italy
  • Live Birth
  • Maternal Exposure
  • Ontario
  • Patient Admission
  • Pregnancy
  • Pregnancy Outcome*
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Serotonin Uptake Inhibitors / adverse effects*
  • Stillbirth
  • Switzerland

Substances

  • Antidepressive Agents, Second-Generation
  • Serotonin Uptake Inhibitors
  • Citalopram