Motherisk Program, The Hospital for Sick Children, Toronto, Ontario, Canada.
J Clin Pharmacol. 2012 May;52(5):766-70. doi: 10.1177/0091270011405524. Epub 2011 Nov 10.
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.
依地普仑是一种用于治疗抑郁症和焦虑症的选择性 5-羟色胺再摄取抑制剂。关于其在妊娠期间使用的安全性信息较少。本研究旨在确定依地普仑在妊娠期间使用是否会增加主要畸形或其他不良结局的风险。作者分析了暴露于依地普仑（n = 212）、其他抗抑郁药（n = 212）和非致畸暴露（n = 212）的孕妇的妊娠结局，并比较了这些结局。在依地普仑暴露组中，有 172 例（81%）活产，32 例（15%）自然流产，6 例（2.8%）治疗性流产，3 例死胎（1.7%）和 3 例主要畸形（1.7%）。各组之间唯一的显著差异是低出生体重（<2500g）和总平均出生体重（P =.225）。然而，与对照组（8.5%）相比，两组抗抑郁药组（15%和 16%）的自然流产率更高（P =.066）。活产率较低（P =.006），总出生体重较低（P <.001），低出生体重（<2500g）发生率较高（P =.009），但与依地普仑有关。与对照组（8.5%）相比，两组抗抑郁药组（15%和 16%）的自然流产率几乎翻了一番，但无统计学意义（P =.066）。依地普仑似乎不会增加主要畸形的风险，但似乎会增加低出生体重的风险，这与<2500g 体重的婴儿增加有关。此外，两组抗抑郁药组自发性流产率较高，这证实了先前的发现。
