Risks associated with antipsychotic treatment in pregnancy: Comparative cohort studies based on electronic health records

被引：28

作者：

Petersen, Irene ^{[1
,2
]}

Sammon, Cormac J. ^{[1
]}

McCrea, Rachel L. ^{[1
]}

Osborn, David P. J. ^{[3
,4
]}

Evans, Stephen J. ^{[5
]}

Cowen, Phillip J. ^{[6
]}

Nazareth, Irwin ^{[1
]}

机构：

[1] UCL, Dept Primary Care & Populat Hlth, Rowland Hill St, London NW3 2PF, England

[2] Aarhus Univ, Dept Clin Epidemiol, Olof Palmes Alle 43-45, DK-8200 Aarhus N, Denmark

[3] UCL, Div Psychiat, 6th Floor,Maple House,149 Tottenham Court Rd, London W1T 7NF, England

[4] Camden & Islington NHS Fdn Trust, London NW1 0PE, England

[5] London Sch Hyg & Trop Med, Dept Med Stat, Keppel St, London WC1E 7HT, England

[6] Warneford Hosp, Univ Dept Psychiat, Oxford OX3 7JX, England

来源：

SCHIZOPHRENIA RESEARCH | 2016年 / 176卷 / 2-3期

关键词：

Antipsychotic treatment; Pregnancy; Electronic health records; PRIMARY-CARE; ATYPICAL ANTIPSYCHOTICS; DRUGS; OUTCOMES; MEDICATION; EXPOSURE; DATABASE; PERIODS; WEIGHT; SAFETY;

D O I：

10.1016/j.schres.2016.07.023

中图分类号：

R749 [精神病学];

学科分类号：

100205 ;

摘要：

Background: Limited information is available on whether antipsychotics prescribed in pregnancy are associated with increased risks of adverse outcomes. Methods: We used electronic health records from pregnant women and their children to examine risks of adverse maternal and child outcomes in three cohorts of women who: (A) received antipsychotic treatment in pregnancy (n=416) (B) discontinued antipsychotic treatment before pregnancy (n=670), and (C) had no records of antipsychotic treatment before or during pregnancy (n=318,434). Absolute and risk ratios were estimated and adjusted for health and lifestyle and concomitant medications. Results: Caesarean section was more common in cohort A (25%) than C (18%), but non-significant after adjustment for health and lifestyle factors (Risk Ratio (adj.) 1.09 (95% CI: 0.92, 1.30). Proportion of gestational diabetes was similar in cohort A (2.6%) and B (2.7%), but lower in A than B after adjustments (RRadj: 0.43 (0.20, 0.93). Premature birth/low birthweight were more common in cohort A (10%) than B (4.3%) and C (3.9%), A versus B (RRadj: 2.04 (1.13, 3.67), A versus C (RRadj: 1.43 (0.99, 2.05). Major congenital malformations were more common in A (3.4%), than B (2.2%) and C (2%). However no significant difference was observed (A versus B: RRadj: 1.79 (0.72, 4.47) A versus C RRadj: 1.59 (0.84, 3.00)). Risks estimates were similar for women prescribed atypical and typical antipsychotics. Conclusions: Antipsychotic treatment in pregnancy carries limited risks of adverse pregnancy and birth outcomes once adjustments have been made for health and lifestyle factors. (C) 2016 Elsevier B.V. All rights reserved.

引用

页码：349 / 356

页数：8

共 40 条

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