Use of antipsychotics in early pregnancy and risk of maternal and neonatal complications
To assess the association between the use of antipsychotics in early pregnancy and the risk of maternal and neonatal metabolic complications.
We conducted a retrospective population-based cohort study (January 1, 2010 to December 31, 2016) using the Taiwan Health and Wellbeing Database. Pregnant women (18 to 49 years old) were grouped into antipsychotic users (ie, received oral antipsychotic monotherapy during the first 20 weeks of pregnancy) and non-users. Antipsychotic users were further categorized into first-generation antipsychotic users and second-generation antipsychotic users. Propensity score methods, including matching and inverse probability of treatment weighting, were used to balance the covariates. Conditional logistic regression and Cox proportional hazards models were used to compare maternal (gestational diabetes, preterm birth) and neonatal (low birth weight) risks. [LBW]macrosomia).
Antipsychotic users had a significantly higher risk of preterm birth than nonusers (adjusted RR, 1.29; 95% CI, 1.04 to 1.60), but the risk of gestational diabetes mellitus ( RR, 1.21, 95% CI, 0.94 to 1.56), LBW (odds ratio [OR], 1.07; 95% CI, 0.84 to 1.37) and macrosomia (OR, 1.36; 95% CI, 0.63 to 2.92) did not differ between the two groups. Among women who received antipsychotics, the risk of IPN was significantly higher in users of second-generation antipsychotics than in users of first-generation antipsychotics (adjusted OR, 1.32; 95% CI, 1 .04 to 1.68).
This study found that the use of antipsychotics in early pregnancy did not lead to an increased risk of metabolic complications for either mothers or newborns. For women requiring treatment with antipsychotics during pregnancy, they should be monitored for the risk of preterm delivery and low birth weight.