Pregnancy Outcome of Women Using Atypical Antipsychotic Drugs: A Prospective Comparative Study
J Clin Psychiatry 2005;66(4):444-449
© Copyright 2014 Physicians Postgraduate Press, Inc.
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A substantial number of women of
childbearing age suffer from schizophrenia and other mental
illnesses that require the use of antipsychotic drugs. Atypical
antipsychotics have been on the market since the mid-1990s, and
to date there are no prospective comparative studies regarding
use during pregnancy.
Objectives: (1) To determine whether atypical
antipsychotics increase the rate of major malformations above the
1% to 3% baseline risk seen in the general population. (2) To
examine rates of spontaneous and therapeutic abortions, rates of
stillbirths, birth weight, and gestational age at birth.
Method: The cohort was composed of pregnant
women who contacted the Motherisk Program in Canada or the
Israeli Teratogen Information Service in Israel and women who
were recruited from the Drug Safety Research Unit database in
England. Women who had been exposed to atypical antipsychotics
were matched to a comparison group of pregnant women who had not
been exposed to these agents.
Results: Data were obtained on 151 pregnancy
outcomes that included exposure to olanzapine (N = 60), risperidone
(N = 49), quetiapine (N = 36), and clozapine (N = 6). Among women
exposed to an atypical antipsychotic, there were 110 live births
(72.8%), 22 spontaneous abortions (14.5%), 15 therapeutic
abortions (9.9%), and 4 stillbirths (2.6%). Among babies of women
in this group, there was 1 major malformation (0.9%), and the
mean ± SD birth weight was 3341 ± 685 g. There were no
statistically significant differences in any of the pregnancy
outcomes of interest between the exposed and comparison groups,
with the exceptions of the rate of low birth weight, which was
10% in exposed babies compared with 2% in the comparison group
(p = .05), and the rate of therapeutic abortions (p = .003).
Conclusion: These results suggest that atypical
antipsychotics do not appear to be associated with an increased
risk for major malformations.