Refereed journal article or data article (A1)
Second-generation antipsychotics and pregnancy complications
List of Authors: Maria Ellfolk, Maarit K. Leinonen, Mika Gissler, Anna-Maria Lahesmaa-Korpinen, Leena Saastamoinen, Marja-Leena Nurminen, Heli Malm
Publisher: SPRINGER HEIDELBERG
Publication year: 2020
Journal: European Journal of Clinical Pharmacology
Journal acronym: EUR J CLIN PHARMACOL
Volume number: 76
Issue number: 1
Start page: 107
End page: 115
Number of pages: 9
ISSN: 0031-6970
eISSN: 1432-1041
DOI: http://dx.doi.org/10.1007/s00228-019-02769-z
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/43871102
Purpose To study if second-generation antipsychotic (S-GA) use during pregnancy is associated with an increased risk of pregnancy and neonatal complications.
Methods A population-based birth cohort study using national register data extracted from the "Drugs and Pregnancy" database in Finland, years 1996-2016. The sampling frame included 1,181,090 pregnant women and their singleton births. Women were categorized into three groups: exposed to S-GAs during pregnancy (n = 4225), exposed to first-generation antipsychotics (F-GAs) during pregnancy (n = 1576), and unexposed (no purchases of S-GAs or F-GAs during pregnancy, n = 21,125). Pregnancy outcomes in S-GA users were compared with those in the two comparison groups using multiple logistic regression models.
Results Comparing S-GA users with unexposed ones, the risk was increased for gestational diabetes (adjusted odds ratio, OR 1.43; 95% CI 1.25-1.65), cesarean section (OR 1.35; 95% CI 1.18-1.53), being born large for gestational age (LGA) (OR 1.57; 95% CI 1.14-2.16), and preterm birth (OR 1.29; 95% CI 1.03-1.62). The risk for these outcomes increased further with continuous S-GA use. Infants in the S-GA group were also more likely to suffer from neonatal complications. Comparing S-GA users with the F-GA group, the risk of cesarean section and LGA was higher (OR 1.25, 95% CI 1.03-1.51; and OR 1.89, 95% CI 1.20-2.99, respectively). Neonatal complications did not differ between the S-GA and F-GA groups.
Conclusions Prenatal exposure to S-GAs is associated with an increased risk of pregnancy complications related to impaired glucose metabolism. Neonatal problems are common and occur similarly in S-GA and F-GA users.
Downloadable publication This is an electronic reprint of the original article. |