Teratology Information, Department of Emergency Medicine Services, Helsinki University and Helsinki University Hospital, Tukholmankatu 17, 00029, Helsinki, Finland.
Information Services Department, Unit of Statistics and Registers, National Institute for Health and Welfare, PL 30, 00271, Helsinki, Finland.
Eur J Clin Pharmacol. 2020 Jan;76(1):107-115. doi: 10.1007/s00228-019-02769-z. Epub 2019 Nov 3.
To study if second-generation antipsychotic (S-GA) use during pregnancy is associated with an increased risk of pregnancy and neonatal complications.
A population-based birth cohort study using national register data extracted from the "Drugs and Pregnancy" database in Finland, years 1996-2016. The sampling frame included 1,181,090 pregnant women and their singleton births. Women were categorized into three groups: exposed to S-GAs during pregnancy (n = 4225), exposed to first-generation antipsychotics (F-GAs) during pregnancy (n = 1576), and unexposed (no purchases of S-GAs or F-GAs during pregnancy, n = 21,125). Pregnancy outcomes in S-GA users were compared with those in the two comparison groups using multiple logistic regression models.
Comparing S-GA users with unexposed ones, the risk was increased for gestational diabetes (adjusted odds ratio, OR 1.43; 95% CI 1.25-1.65), cesarean section (OR 1.35; 95% CI 1.18-1.53), being born large for gestational age (LGA) (OR 1.57; 95% CI 1.14-2.16), and preterm birth (OR 1.29; 95% CI 1.03-1.62). The risk for these outcomes increased further with continuous S-GA use. Infants in the S-GA group were also more likely to suffer from neonatal complications. Comparing S-GA users with the F-GA group, the risk of cesarean section and LGA was higher (OR 1.25, 95% CI 1.03-1.51; and OR 1.89, 95% CI 1.20-2.99, respectively). Neonatal complications did not differ between the S-GA and F-GA groups.
Prenatal exposure to S-GAs is associated with an increased risk of pregnancy complications related to impaired glucose metabolism. Neonatal problems are common and occur similarly in S-GA and F-GA users.
研究第二代抗精神病药物（S-GA）在孕期使用是否与妊娠和新生儿并发症风险增加有关。
这是一项基于人群的出生队列研究，使用芬兰“药物与妊娠”数据库中提取的全国登记数据，研究时间为 1996 年至 2016 年。抽样框架包括 1181090 名孕妇及其单胎分娩。女性分为三组：孕期使用 S-GA（n=4225）、孕期使用第一代抗精神病药物（F-GA）（n=1576）和未暴露（孕期未购买 S-GA 或 F-GA，n=21125）。使用多因素逻辑回归模型比较 S-GA 使用者与两个对照组的妊娠结局。
与未暴露者相比，S-GA 使用者的妊娠糖尿病（调整后的优势比[OR] 1.43；95%可信区间[CI] 1.25-1.65）、剖宫产（OR 1.35；95%CI 1.18-1.53）、巨大儿（OR 1.57；95%CI 1.14-2.16）和早产（OR 1.29；95%CI 1.03-1.62）的风险增加。随着 S-GA 连续使用，这些风险进一步增加。S-GA 组的婴儿也更有可能出现新生儿并发症。与 F-GA 组相比，S-GA 使用者的剖宫产和巨大儿风险更高（OR 1.25，95%CI 1.03-1.51；和 OR 1.89，95%CI 1.20-2.99）。S-GA 和 F-GA 组之间的新生儿并发症无差异。
产前暴露于 S-GA 与与葡萄糖代谢受损相关的妊娠并发症风险增加有关。新生儿问题很常见，在 S-GA 和 F-GA 使用者中同样常见。
