Takeaway
- This study found no significant evidence of an increased risk of gestational diabetes mellitus (GDM) in women who continued any type of antipsychotic agent during any time in pregnancy or in different trimesters compared with those who stopped.
- Findings suggest that women should not stop their regular antipsychotic prescriptions during pregnancy because of the fear of GDM and should discuss their individual cases with physicians.
Study design
- Two population-based cohort studies included 3114 women with first pregnancies using data from the UK The Health Improvement Network (THIN; n=2351) and Hong Kong Clinical Data Analysis and Reporting System (HK CDARS; n=763).
- GDM risk was compared in women exposed to antipsychotics before and during pregnancy (continuers) to women exposed to antipsychotics before pregnancy only (discontinuers).
- Funding: None.
- A total of 171 (5.49%) women were diagnosed with GDM in both databases (2.55% in THIN and 14.55% in CDARS).
- Compared with discontinuers, the adjusted OR (aOR, 95% CI) of GDM in continuers was 0.73 (0.43‐1.25) in THIN and 1.16 (0.78‐1.73) in CDARS.
- until first trimester: 1.26 (0.42-3.78) in THIN; 1.46 (0.77-2.79) in CDARS;
- until second trimester: 0.84 (0.11-6.48) in THIN; 0.58 (0.20-1.70) in CDARS; and
- until third trimester: 0.90 (0.38-2.10) in THIN; 1.21 (0.77-1.90) in CDARS.
- The use of first-generation antipsychotics (FGAs) or second-generation antipsychotics (SGAs) showed no association with an increased risk of GDM.
- FGAs: aOR, 0.57; 95% CI, 0.20-1.65 in THIN and aOR, 1.15; 95% CI, 0.71-1.86 in CDARS; and
- SGAs: aOR, 0.98; 95% CI, 0.51-1.88 in THIN and aOR, 1.04; 95% CI, 0.58-1.85 in CDARS.
- Possibility of underestimation of exposure duration or overall exposure episodes in the UK cohort.
- Relatively small sample size.
References
References
