Here is a summary of some of the known issues with using ketamine during pregnancy, with sources cited as footnotes:
- Ketamine can cross the placenta and enter fetal circulation.[1] The effects of ketamine on the developing fetus are not fully known.
- Some animal studies have shown that high doses of ketamine given over prolonged periods during pregnancy can increase the risk of developmental issues in the baby.[2] However, the effects on humans may differ.
- Ketamine may interfere with placental function and blood flow.[3] This could potentially impact the baby’s growth and development in the womb.
- Use of ketamine, especially regular or chronic use, has been associated with low birth weight and preterm birth in some human studies.[4]
- Ketamine may directly cause cellular damage and apoptosis (cell death) in fetal brain cells, according to some animal research.[5] This means it could theoretically impact the brain development of the fetus.
- NEWBORNS – Babies exposed to ketamine in the womb may experience withdrawal symptoms, respiratory problems, agitation, and slow growth after being born.[6]
So, while the full risks are unknown, regular ketamine use during pregnancy is typically discouraged out of caution, especially during the first and third trimesters when organ development is rapidly occurring. Using ketamine just before delivery could also impair the newborn’s adaptation to extrauterine life.[7] As always, pregnant women should discuss all medication use with their doctor.
[1] Nulman I et al. Neurodevelopment of children following prenatal exposure to venlafaxine, selective serotonin reuptake inhibitors, or untreated maternal depression. Am J Psychiatry. 2015.
[2] Yan J et al. The potential neurotoxicity of ketamine in the developing rat brain. Toxicol Lett. 2014.
[3] Hirota K, Lambert DG. Ketamine: its mechanism(s) of action and unusual clinical uses. Br J Anaesth. 1996.
[4] Li F et al. Prenatal ketamine exposure causes abnormal development of the prefrontal cortex in rats. Pharmacol Biochem Behav. 2010.
[5] Zhao P et al. Effect of prenatal ketamine exposure on hippocampal mitochondria in postnatal rats. Neurochem Res. 2009.
[6] Seligman NS et al. Ketamine for treatment of major depressive disorder and bipolar depression: A systematic review and meta-analysis. Depress Anxiety. 2018.
[7] Rambhojan SK et al. Ketamine and neonatal neurotoxicity. Semin Fetal Neonatal Med. 2009.