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Antipsychotic drug use during pregnancy did not increase risk for adverse outcomes

Women taking antipsychotic drugs during pregnancy did not have significantly increased risk for adverse pregnancy outcomes compared with peers not taking antipsychotic drugs, according to study findings in BMJ.

“There has been a considerable rise in antipsychotic medication use in pregnancy, from 3 per 1,000 pregnancies in 2001 to 8 per 1,000 in 2007,” study researcher Simone N. Vigod, MD, MSc, FRCPC, of the University of Toronto, and colleagues wrote. “Decisions about the use of antipsychotic drugs in pregnancy are not straightforward, however. It is recognized that a woman with serious mental illness who discontinues her medication in pregnancy, out of concern for fetal harm, may jeopardize her own mental health and her ability to care for her child after delivery.”

Researchers reviewed medical records for women who delivered children between 2003 and 2012 who were eligible for provincially funded drug coverage. The study cohort included 1,021 women who used at least two antipsychotic medications during pregnancy and 1,021 matched non-users.

In unmatched analysis, antipsychotic drug users had higher rates for gestational diabetes (7.7% vs. 6.2%) and hypertensive disorders of pregnancy (5.2% vs. 3.5%) but not for venous thromboembolism vs. non-users. These differences were no longer significant in matched analysis.

Similarly, antipsychotic drug users had higher rates for preterm birth (14.8% vs. 10.3%) and birth weight below the 97^th percentile (3.7% vs. 2.6%) vs. non-users in unmatched analysis. However, these differences did not remain significant in matched analysis.

“Women requiring antipsychotic medications are at higher absolute risk for certain adverse maternal and perinatal outcomes compared with the general population. As such, it is prudent to closely monitor the medical health of these women before and during pregnancy with particular attention to issues related to diabetes, hypertension, preterm birth, and fetal growth,” Vigod and colleagues wrote. “However, antipsychotic medications themselves do not seem to have an extensive negative impact on important measures of maternal medical and short term perinatal well-being.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.