Exposure to Prenatal Antipsychotics Seems Safe

Exposure to prenatal antipsychotics does not appear to be associated with an increased risk for attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), or small for gestational age, according to a study published online Aug. 16 in JAMA Internal Medicine.

Zixuan Wang, from the UCL School of Pharmacy in London, and colleagues examined the correlation between prenatal antipsychotics exposure and risk for birth and neurodevelopmental problems in a population-based cohort of children born between January 2001 and January 2015. The cohorts included 333,749 mother-child pairs for ADHD and 411,251 pairs for ASD, preterm-birth, and small-for-gestational-age analyses.

The researchers found that 3.95, 2.12, 8.24, and 1.70 percent of the offspring had a diagnosis of ADHD, ASD, preterm birth, and small for gestational age, respectively. When comparing gestationally exposed with gestationally nonexposed participants, the weighted hazard ratio was 1.16 (95 percent confidence interval, 0.83 to 1.61) and 1.06 (95 percent confidence interval, 0.70 to 1.60) for ADHD and ASD, respectively, while the weighted odds ratio was 1.40 (95 percent confidence interval, 1.13 to 1.75) and 1.36 (95 percent confidence interval, 0.86 to 2.14) for preterm birth and small for gestational age, respectively. No correlation was seen when comparing gestationally exposed individuals to those with past exposure or in a sibling-matched analysis.

"If pregnant women have a clinical need for antipsychotics (including first-generation and second-generation antipsychotics), clinicians should not stop administering regular treatment because of a fear of birth outcomes with ADHD, ASD, preterm birth, and small for gestational age," the authors write.

Two authors disclosed financial ties to the pharmaceutical industry.