Prophylactic esketamine to reduce postpartum depression in primiparae: A multicentre, double-blind, randomised clinical trial
Primary resultResult — go to the resultAdjusted relative risk 0.57 95% CI 0.35–0.94Authors' conclusion
Peri-operative adjunctive administration of esketamine is relatively safe and can prevent PPD in primi-parae without predisposition to prenatal depression in the short term.
Study context
- Population
- Primiparae scheduled for elective caesarean section with Edinburgh Postnatal Depression Scale (EPDS) score less than 10, three academic hospitalsmodified ITT analysis
- Participants
- 322 participants
- Comparison
- Esketamine vs saline
- Primary endpoint
- Total incidence of PPD
- Follow-up
- Within 3 months postpartum
Methodological detailsprospective, double-blind, multicentre
- Prospective
- Double-blind
- Multicentre
Primary result
As reported in the abstract
Adjusted relative risk
0.57
95% CI 0.35–0.94
P = 0.028
By group
Esketamine vs Control
adjusted RR 0.57 (95% CI 0.35–0.94); P = 0.028
Secondary outcomes
| Outcome | Esketamine | Control | Adjusted RR (95% CI) | P value | |
|---|---|---|---|---|---|
| PPD incidence · 7 days postpartum | 4.89 % | 15.19% | 0.32 (0.15–0.72) | P = 0.005 | |
| 0.10.31310Adjusted relative risk (log scale) |
PPD incidence and EPDS scores · 1, 2 and 3 months postpartum
- No significant differences
Safety
- Mild central nervous events during esketamine treatment
- 10.98% · dizziness · hallucination 10.37% · dissociation 5.49%
Original publication
Prophylactic esketamine to reduce postpartum depression in primiparae: A multicentre, double-blind, randomised clinical trial. Eur J Anaesthesiol. Published 28 January 2026. doi:10.
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