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ECT in Pregnancy: A Review of the Literature From 1941 to 2007

From the Department of Psychiatry and Behavioral Sciences and the Department of Neuroscience, Johns Hopkins University, Baltimore, Maryland.

Address correspondence and reprint requests to Eric L. Anderson, Department of Psychiatry and Behavioral Sciences, Johns Hopkins Hospital, 600 N. Wolfe Street, Meyer 131, Baltimore, MD 21287. E-mail: eander32{at}jhmi.edu

Objective: To review the literature on the use of electroconvulsive therapy (ECT) during pregnancy and to discuss its risks and benefits for treating severe mental illness during pregnancy.

Method: PubMed and PsycINFO databases were searched for English or English-translated articles, case reports, letters, chapters, and Web sites providing original contributions and/or summarizing prior data on ECT administration during pregnancy.

Results: A total of 339 cases were found. The majority of patients were treated for depression and at least partial remission was reported in 78% of all cases where efficacy data were available. Among the 339 cases reviewed, there were 25 fetal or neonatal complications, but only 11 of these, which included two deaths, were likely related to ECT. There were 20 maternal complications reported and 18 were likely related to ECT.

Conclusions: Although there are limited available data in the literature, it seems that ECT is an effective treatment for severe mental illness during pregnancy and that the risks to fetus and mother are low.

Key Words: ECT • pregnancy • depression • safety • neonatal

Abbreviations: ECT = electroconvulsive therapy; MDD = major depressive disorder; MVA= motor vehicle accident.

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