Antipsychotics during pregnancy may raise risk of gestational diabetes

Women who take certain antipsychotic medications and continue the use of these medications through pregnancy may be at increased risk for gestational diabetes.

There is a well-established link between some antipsychotic medication and metabolic side effects, such as weight gain and diabetes, which are risk factors for gestational diabetes. Gestational diabetes, a complication of pregnancy, can lead to problems including preeclampsia, cesarean delivery and neonatal hypoglycemia. An estimated 5 to 9 percent of women develop gestational diabetes during pregnancy. In addition, up to 50 percent of women with gestational diabetes later develop type 2 diabetes.

The researchers looked at the risk of developing gestational diabetes associated with continued use of several antipsychotic medications, including aripiprazole (Abilify), ziprasidone (Geodon), quetiapine (Seroquel), risperidone (Risperdal) and olanzapine (Zyprexa), during pregnancy.

The study involved a large group of women enrolled in Medicaid who were pregnant, did not have diabetes and had been taking antipsychotic medication in the three months prior to pregnancy. They compared those who continued medication during pregnancy with those who stopped during pregnancy.

The study found that depending on the medication, the absolute risk of gestational diabetes among the study participants continuing medication was 4.2 percent to 12 percent; among those stopping medication during pregnancy, it ranged from 3.8 percent to 4.7 percent.

For two of the five antipsychotic medications examined, olanzapine and quetiapine, there was an increased risk for gestational diabetes compared with women who discontinued these medications, after adjustment for potential confounding variables. There was not an increased risk of gestational diabetes for women taking aripiprazole, ziprasidone and risperidone.

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