Is Antipsychotic Drug Use During Pregnancy Associated with Increased Malformation Rates and Worsening of Maternal and Infant Outcomes? A Systematic Review

Gabriele Sani; Tommaso Callovini; Ottavia Ferrara; Daniele Segatori; Stella Margoni; Alessio Simonetti; Francesco Lisci; Giuseppe Marano; Alessia Fischetti; Georgios Kotzalidis; Federica Di Segni; Federica Fiaschè; Delfina Janiri; Lorenzo Moccia; Giovanni Manfredi; Alessandro Alcibiade; Caterina Brisi; Flavia Grisoni; Gianmarco Stella; Evelina Bernardi; Andrea Brugnami; Michele Ciliberto; Maria Spera; Romina Caso; Sara Rossi; Gianluca Boggio; Giulia Mastroeni; Francesca Abate; Eliana Conte; Anna Quintano; Lavinia De Chiara; Laura Monti; Giovanni Camardese; Lucio Rinaldi; Alexia Koukopoulos; Daniela Chieffo; Gloria Angeletti; Marianna Mazza

doi:10.2174/1570159X22666240516151449

Is Antipsychotic Drug Use During Pregnancy Associated with Increased Malformation Rates and Worsening of Maternal and Infant Outcomes? A Systematic Review

Authors: Sani G.¹, Callovini T.², Ferrara O.³, Segatori D.⁴, Margoni S.⁴, Simonetti A.⁵, Lisci F.⁴, Marano G.⁵, Fischetti A.⁴, Kotzalidis G.⁵, Di Segni F.⁶, Fiaschè F.⁷, Janiri D.⁵, Moccia L.⁸, Manfredi G.⁹, Alcibiade A.⁶, Brisi C.⁴, Grisoni F.⁴, Stella G.³, Bernardi E.³, Brugnami A.³, Ciliberto M.⁴, Spera M.¹⁰, Caso R.¹⁰, Rossi S.³, Boggio G.⁴, Mastroeni G.³, Abate F.⁴, Conte E.¹⁰, Quintano A.⁴, De Chiara L.¹¹, Monti L.¹², Camardese G.⁸, Rinaldi L.¹, Koukopoulos A.¹³, Chieffo D.¹², Angeletti G.¹⁴, Mazza M.⁸
Affiliations:
1. Department of Psychiatry,, Fondazione Policlinico Universitario Agostino Gemelli IRCCS,
2. Department of Medicine and Surgery,, University of Milano-Bicocca
3. Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore
4. Department of Neuroscience, Section of Psychiatry,, Università Cattolica del Sacro Cuore
5. Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS
6. Psychiatry Residency Training Programme, Faculty of Medicine and Psychology, Sapienza University of Rome
7. ASL RM1, Presidio Ospedaliero San Filippo Neri, Servizio Psichiatrico di Diagnosi e Cura
8. Department of Psychiatry,, Fondazione Policlinico Universitario Agostino Gemelli IRCCS
9. UOC Psichiatria, Day Hospital, Sant'Andrea Teaching Hospital, Sapienza University of Rome
10. Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore,
11. , Struttura Residenziale Psichiatrica Samadi S.p.A.
12. UOS Clinical Psychology, Clinical Government, Fondazione Policlinico Universitario Agostino Gemelli IRCCS
13. Azienda Ospedaliera Universitaria Policlinico Umberto I, Viale dellUniversità 30
14. Sapienza University of Rome, Sant'Andrea Hospital, Sapienza University of Rome
Issue: Vol 22, No 14 (2024)
Pages: 2402-2421
Section: Neurology
URL: https://ruspoj.com/1570-159X/article/view/644570
DOI: https://doi.org/10.2174/1570159X22666240516151449
ID: 644570

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Abstract

:There is much debate about continuing antipsychotic medication in patients who need it when they become pregnant because benefits must be weighed against potential teratogenic and malformation effects related to antipsychotics themselves. To address this, we conducted a systematic review on the PubMed, PsycINFO and CINHAL databases and the ClinicalTrials.gov register using the following strategy: (toxicity OR teratogenicity OR malformation* OR \"birth defect*\" OR \"congenital abnormality\" OR \"congenital abnormalities\" OR \"brain changes\" OR \"behavioral abnormalities\" OR \"behavioral abnormalities\") AND antipsychotic* AND (pregnancy OR pregnant OR lactation OR delivery OR prenatal OR perinatal OR post-natal OR puerperium) on September 27, 2023. We found 38 studies to be eligible. The oldest was published in 1976, while most articles were recent. Most studies concluded that the antipsychotics, especially the second-generation antipsychotics, were devoid of teratogenic potential, while few studies were inconclusive and recommended replication. Most authoritative articles were from the Boston area, where large databases were implemented to study the malformation potential of psychiatric drugs. Other reliable databases are from Northern European registers. Overall conclusions are that antipsychotics are no more related to malformations than the disorders themselves; most studies recommend that there are no reasons to discontinue antipsychotic medications in pregnancy

Keywords

Pregnancy, malformations, major, teratogenicity, lactation, antipsychotic drugs, second generation antipsychotics.

References

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Is Antipsychotic Drug Use During Pregnancy Associated with Increased Malformation Rates and Worsening of Maternal and Infant Outcomes? A Systematic Review

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