Antipsychotic Use During Pregnancy and Risk for Gestational Diabetes

CNS Drugs journal brought out the study that aimed to assess whether antipsychotic use during pregnancy is associated with gestational diabetes and found that drugs like Olanzapine, clozapine and quetiapine used during pregnancy were associated with increased risks for gestational diabetes and the infant being large for gestational age. 

A Swedish national register‐based cohort study included over 1 lac singleton births. Antipsychotics were divided into 728 first-generation antipsychotics, 1710 in high-risk metabolic second-generation antipsychotics including olanzapine, clozapine and quetiapine, and 541 in other second-generation antipsychotics. The risks for gestational diabetes, foetal growth disturbances, pre-eclampsia, caesarean section and preterm labour were assessed. Women treated during pregnancy were compared to women not treated during pregnancy and to women who used antipsychotics before/after but not during pregnancy.

The risk ratio for gestational diabetes for women treated with high-risk metabolic second-generation antipsychotics during pregnancy was 2.2 compared to untreated pregnant women and 1.8 compared to women treated before/after pregnancy. Exposed infants had an increased risk of being large for gestational age while other antipsychotics were not associated with metabolic risks.

Hence, the researchers concluded that Olanzapine, clozapine and quetiapine used during pregnancy were associated with increased risks for gestational diabetes and the infant being large for gestational age. Enhanced metabolic monitoring should be considered for pregnant women using these drugs.