A prospective cohort study of antipsychotic medications in pregnancy: the first 147 pregnancies and 100 one year old babies

Jayashri Kulkarni, Roisin Worsley, Heather Alison Gilbert, Emorfia Gavrilidis, Tamsyn Van Rheenen, Wei Chun Wang, Kay Madelon McCauley, Paul Bernard Fitzgerald

Research output: Contribution to journalArticleResearchpeer-review

86 Citations (Scopus)

Abstract

Background: Many women diagnosed with varying psychiatric disorders take antipsychotic medications during pregnancy. The safety of antipsychotic medications in pregnancy is largely unknown. Methods: We established the National Register of Antipsychotic Medications in Pregnancy in 2005. Women who are pregnant and taking an antipsychotic medication are interviewed every 6 weeks during pregnancy and then followed until their babies are one year old. The baby s progress is closely followed for the first year of life. Findings: As of April 18 2012, 147 pregnancies had been followed through to completion. There were 142 live births and data is available for 100 one year old babies. 18 of babies were born preterm, with a higher dose of antipsychotic medication correlating to an increased likelihood of premature delivery; 43 of babies required special care nursery or intensive care after birth; 37 had any degree of respiratory distress and 15 of babies developed withdrawal symptoms. Congenital anomalies were seen in eight babies. Most pregnancies resulted in the birth of live, healthy babies. The use of mood stabilisers or higher doses of antipsychotics during pregnancy increased the likelihood of babies experiencing respiratory distress or admission to Special Care Nursery or Neonatal Intensive Care Units. Conclusion: There is a great need for safety and efficacy information about the use of antipsychotic medications in pregnancy. Live, healthy babies are the most common outcome following the use of antipsychotic medication in pregnancy, but clinicians should be particularly mindful of neonatal problems such as respiratory distress. ? 2014 Kulkarni et al.
Original languageEnglish
Article numbere94788
Number of pages6
JournalPLoS ONE
Volume9
Issue number5
DOIs
Publication statusPublished - 2014

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