Coughlin et al. Obstetric and neonatal outcomes after antipsychotic medication exposure in pregnancy
Why should you read about this topic?
With more and more people using antipsychotic medications for bipolar disorder, schizophrenia, and unipolar depression, it is essential to understand the association between the use of these medications and pregnancy outcomes.
What were the authors trying to do?
Assess the association between the use of antipsychotic medication during pregnancy and adverse obstetric and neonatal outcomes.
Who participated and in what setting?
Women enrolled in 13 cohort studies, including 6,289 antipsychotic-exposed and 1,618,039 unexposed pregnancies.
What was the study design?
Systematic review and meta-analysis
What were the main outcome measures?
Congenital malformations, fetal demise, gestational age, and birth weight
What were the results?
Antipsychotic exposure was associated with an increased risk of major malformations, preterm delivery, termination of pregnancy, and SGA births. There was no difference in risk of major malformations comparing typical with atypical antipsychotics.
What is the most interesting image in the paper?
What were the study strengths and weaknesses?
Strengths: Sound methodology; large sample size. Weaknesses: limited adjustment for potential confounding variables; large degree of heterogeneity of effect for some outcomes; limited evaluation of publication bias
What does the study contribute for your practice?
Women taking antipsychotic medication during pregnancy are at increased risk for adverse birth outcomes