Obstetric Outcomes With Second-Generation Long-Acting Injectable Versus Oral Antipsychotics

Objective: The purpose of this study is to evaluate obstetric outcomes in pregnant women who received second-generation long-acting injectable antipsychotics (LAIAs) compared to a control group who received second-generation oral antipsychotics.

Methods: This was a retrospective study utilizing a global cohort of 148 health care organizations grouped into a network within the TriNetX database. Pregnant patients of any trimester were grouped into 2 cohorts: (1) exposure to long-acting aripiprazole, risperidone, paliperidone, or olanzapine (n=2,082) and (2) exposure to the corresponding oral formulations (n=31,376) and propensity matched. The primary outcome was the occurrence of one of the following obstetric complications: gestational diabetes, preeclampsia, eclampsia, or a newly diagnosed hypertensive disorder. Cesarean section rates were also assessed.

Results: After propensity matching, each cohort yielded 2,025 patients. No intergroup differences were observed in the composite primary end point, performed postmatching (odds ratio 0.95; 95% CI, 0.76-1.18; P=.61). No difference in rates of cesarean section was observed.

Conclusion: Similar rates of gestational diabetes, eclampsia, preeclampsia, and maternal hypertensive disorders were observed in women receiving long-acting injectable and oral second-generation antipsychotics.