Is Lexapro safe during pregnancy?

What does the evidence say about Lexapro during pregnancy?

1. More than 15,000 pregnancies exposed to citalopram or escitalopram have been published, and most studies have not found a higher chance of birth defects. 1
2. Miscarriage rates did not rise in a study of citalopram and escitalopram, though some research suggests that taking either one throughout pregnancy might raise the chance of preterm delivery and low birth weight. 1
3. Nine previously published SSRI birth defect associations came back consistent with no association in a Bayesian analysis of nearly 28,000 mothers, with the remaining signals concentrated in paroxetine and fluoxetine rather than citalopram or escitalopram. 2
4. Persistent pulmonary hypertension was recorded in about 32 per 10,000 births exposed to an SSRI late in pregnancy versus 21 per 10,000 unexposed births, and the association shrank to a non-significant odds ratio of 1.10 after adjusting for depression. 3
5. Depression during pregnancy has itself been linked to poor fetal growth, going into labor too early, and low birth weight, which puts the risks of the illness on the same scale as the risks of the medication. 4

Is Lexapro safe in each trimester?

• First trimester. MotherToBaby summarizes published information on more than 15,000 pregnancies exposed to citalopram or escitalopram, and most studies have not found a higher chance of birth defects. A few reports have hinted at heart defects, but those studies have flaws that make the medication hard to separate from other factors.
• Second trimester. Escitalopram is often continued through the middle of pregnancy. Some studies connect use across the whole pregnancy with preterm delivery and lower birth weight, and depression on its own carries similar associations, so the two are hard to untangle. This is a sensible point to review your dose and how you actually feel.
• Third trimester. Late exposure can leave a newborn temporarily jittery, sleepy, or hard to feed. There is also a small signal for persistent pulmonary hypertension: about 32 cases per 10,000 SSRI-exposed births compared with 21 per 10,000 unexposed, and most of that gap disappears once depression is factored in.