Is Antipsychotic Drug Use During Pregnancy Associated with Increased Malformation Rates and Worsening of Maternal and Infant Outcomes? A Systematic Review-Reference-Cited by-同舟云学术

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

Published:2024-12 Issue:14 Volume:22 Page:2402-2421
ISSN:1570-159X
Container-title:Current Neuropharmacology
language:en
Short-container-title:CN

Author:

Sani Gabriele¹²,Callovini Tommaso³,Ferrara Ottavia Marianna²,Segatori Daniele²,Margoni Stella²,Simonetti Alessio¹²,Lisci Francesco Maria²,Marano Giuseppe¹²,Fischetti Alessia²,Kotzalidis Georgios D.¹⁴,Di Segni Federica⁵,Fiaschè Federica⁶,Janiri Delfina¹²,Moccia Lorenzo¹²,Manfredi Giovanni⁷,Alcibiade Alessandro⁸⁹,Brisi Caterina²,Grisoni Flavia²,Stella Gianmarco²,Bernardi Evelina²,Brugnami Andrea²,Ciliberto Michele²,Spera Maria Chiara²,Caso Romina²,Rossi Sara²,Boggio Gianluca²,Mastroeni Giulia²,Abate Francesca²,Conte Eliana²¹⁰,Quintano Anna²,De Chiara Lavinia¹¹¹²,Monti Laura¹³,Camardese Giovanni¹²,Rinaldi Lucio¹²,Koukopoulos Alexia E.¹⁴,Chieffo Daniela Pia Rosaria¹⁵¹⁶,Angeletti Gloria¹⁷,Mazza Marianna¹²

Affiliation:

1. Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy

2. Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy

3. Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy

4. Department of Neurosciences, Mental Health, and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy

5. Psychiatry Residency Training Programme, Faculty of Medicine and Psychology, Sapienza University of Rome, Via di Grottarossa 1035-1039, 00189 Rome, Italy

6. ASL RM1, Presidio Ospedaliero San Filippo Neri, Servizio Psichiatrico di Diagnosi e Cura, Via Martinotti, 20, 00136 Rome, Italy

7. UOC Psichiatria, Day Hospital, Sant'Andrea Teaching Hospital, Sapienza University of Rome, Via di Grottarossa 1035-1039, 00189 Rome, Italy

8. Psychiatry Residency Training Programme, Faculty of Medicine and Psychology, Sapienza University of Rome, Via di Grottarossa 1035-1039, 00189 Rome, Italy

9. Marina Militare Italiana (Italian Navy), Defense Ministry of Italy, Piazza della Marina, 4, 00196 Rome, Italy

10. Early Intervention Unit, ASL Roma 3, 00152 Rome, Italy

11. Struttura Residenziale Psichiatrica Samadi S.p.A., via di Grottarossa Km. 2.200, 00189 Rome, Italy

12. Centro Lucio Bini, Via Crescenzio 42, 00193 Rome, Italy

13. UOS Clinical Psychology, Clinical Government, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy

14. Azienda Ospedaliera Universitaria Policlinico Umberto I, Viale dell’Università 30, 00185 Rome, Italy and Centro Lucio Bini, Via Crescenzio 42, 00193 Rome, Italy

15. UOS Clinical Psychology, Clinical Government, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy

16. Women, Children and Public Health Department, Catholic University of the Sacred Heart, 00168 Rome, Italy

17. Department of Neurosciences, Mental Health, and Sensory Organs (NESMOS), Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy

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

Publisher

Bentham Science Publishers Ltd.