Second-generation antipsychotics and pregnancy complications
Maria Ellfolk1, Maarit K Leinonen2, Mika Gissler2,3,4
1Teratology Information, Department of Emergency Medicine Services, Helsinki University and Helsinki University Hospital, Tukholmankatu 17, 00029, Helsinki, Finland.
European Journal of Clinical Pharmacology
|November 5, 2019
Summary
Second-generation antipsychotic (S-GA) use during pregnancy increases risks for gestational diabetes, cesarean birth, and preterm birth. Neonatal complications were common in S-GA exposed infants, similar to first-generation antipsychotic users.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Health
- Pharmacology
Background:
- Antipsychotic medications are frequently prescribed during pregnancy.
- Understanding the risks associated with second-generation antipsychotics (S-GAs) is crucial for maternal and infant well-being.
Purpose of the Study:
- To investigate the association between prenatal exposure to second-generation antipsychotics (S-GAs) and pregnancy and neonatal complications.
- To compare risks between S-GA users, first-generation antipsychotic (F-GA) users, and unexposed pregnant women.
Main Methods:
- Population-based birth cohort study utilizing Finnish national register data (1996-2016).
- Included 1,181,090 pregnant women and singleton births.
- Compared outcomes in S-GA exposed (n=4225), F-GA exposed (n=1576), and unexposed (n=21,125) groups using logistic regression.
Main Results:
- S-GA use was linked to increased risks of gestational diabetes (aOR 1.43), cesarean section (aOR 1.35), large for gestational age (LGA) (aOR 1.57), and preterm birth (aOR 1.29) compared to unexposed.
- Continuous S-GA use further elevated these risks.
- Neonatal complications were more frequent in S-GA exposed infants.
- S-GA users had higher risks of cesarean section and LGA compared to F-GA users, but neonatal complications were similar.
Conclusions:
- Prenatal S-GA exposure is associated with pregnancy complications, particularly those involving glucose metabolism.
- Neonatal problems are common in infants exposed to S-GAs, with similar rates observed in F-GA exposed infants.
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