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Antipsychotics associated with diabetes in pregnant women
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Women who used antipsychotics during pregnancy had increased risks for gestational diabetes, according to study results.
“Pregnant women treated with antipsychotics are at high risk of unfavorable pregnancy outcomes and, thus, should be closely monitored for gestational diabetes and deviating fetal growth,” study researcher Robert Bodén, MD, PhD, told Healio.com.
Bodén, of the neuroscience department at Uppsala University and the Karolinska Institutet Centre for Pharmacoepidemiology in Stockholm, Sweden, and colleagues performed a population-based cohort study of all women who gave birth in Sweden from July 1, 2005, to Dec. 31, 2009. Data was obtained from three Swedish national health registers: Swedish Prescribed Drug Register, the Medical Birth Register and the National Patient Register.
Women were grouped based on the obesogenic and diabetogenic potential of the antipsychotics they were prescribed. The first group (n=169) filled prescriptions for highly anabolic drugs, including olanzapine (Zyprexia, Lilly) and clozapine, while the second group (n=338) filled prescriptions for other antipsychotics. The researchers excluded women who filled prescriptions of prochlorperazine (Compro, Paddock), levomepromazine and melperone because the drugs are used primarily as antiemetics or anxiolytics with low and intermittently administered doses. Lithium, because of its different pharmacological action, was also excluded from the study. The two groups were compared with the total population of unexposed pregnancies (n=357,696).
Gestational diabetes was more than twice as common in mothers who used antipsychotics, both in the first group (OR=2.44; 95% CI, 1.14-4.24) and in the second group (OR=2.53; 95% CI, 1.48-4.34), compared with the total population. The odds ratios remained similar after controlling for birth order and maternal age, country of origin, cohabitation, smoking and height. Infants exposed to either group of antipsychotics had more than double the risk for low birth weight, and exposure to other psychotics only was associated with increased risks for small birth length and head circumference.
“The increased risk of giving birth to a [small-for-gestational-age] infant observed among women treated with antipsychotics during pregnancy is probably an effect of confounding factors, such as smoking,” the researchers wrote. “Olanzapine and/or clozapine exposure during pregnancy is not associated with infants being born [large for gestational age], except regarding head circumference. This observation deserves to be investigated in future research.”
Disclosure: The researchers report no relevant financial disclosures.