Finland: Prenatal exposure to second-generation antipsychotics (S-GAs) increases the risk of pregnancy complications relating to impaired glucose metabolism, a recent study in the European Journal of Clinical Pharmacology has suggested. Neonatal problems are common and occur similarly in both first-generation antipsychotic (F-GA) and S-GA users.
Because of the increasing use of S-GAs among pregnant women and conflicting data on their safety. Heli Malm, Helsinki University and Helsinki University Hospital, Tukholmankatu, Helsinki, Finland, and colleagues investigated the association between S-GA use during pregnancy and neonatal complications using nationwide register data.
The researchers conducted this population-based birth cohort study using national register data extracted from the "Drugs and Pregnancy" database in Finland, the 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.
Key findings of the study include:
Comparing S-GA users with unexposed ones, the risk was increased for gestational diabetes (adjusted odds ratio, OR 1.43), cesarean section (OR 1.35), being born large for gestational age (LGA) (OR 1.57), and preterm birth (OR 1.29).
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 and OR 1.89, respectively).
Neonatal complications did not differ between the S-GA and F-GA groups.
"Prenatal exposure to second-generation antipsychotics 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," wrote the authors.
The study, "Second-generation antipsychotics and pregnancy complications," is published in the European Journal of Clinical Pharmacology.
DOI: https://doi.org/10.1007/s00228-019-02769-z