Antipsychotic Meds in Pregnancy: Higher Doses Ups Risks for Neonates

The use of antipsychotic medications during pregnancy correlated with preterm delivery, neonatal intensive care, and respiratory distress among newborn babies, an observational study suggests.

The study followed 147 pregnancies, with 142 live births, and included data from 100 of the babies at one year of age. The results were published last month in PLOS ONE. 

Pertinent Points

- Most women taking antipsychotic meds during pregnancy gave birth to healthy babies.

- The most common association with antipsychotic drug use in pregnancy was the need for a special care nursery or intensive care after birth, which was required by 43% of the newborns.

- In addition, 37% of the babies had some respiratory distress.

- 15% of babies
had withdrawal symptoms.

Most babies were healthy at one year postpartum, with the mothers of 96 of the babies reporting their children were progressing well, the authors reported.

Of the 142 live births, 18% were preterm. The researchers noted that a higher dose of antipsychotic medication was associated with an increased likelihood of premature delivery.

The most common complication was the need for special care nursery or intensive care after birth, which was required by 43% of the newborns. And 37% of the babies had some respiratory distress, the authors observed. Again, higher doses of medications were tied to babies who experienced respiratory distress or who were admitted to a NICU.

Only 15% of the babies experienced withdrawal symptoms from in utero exposure to the medications.

"There's been little research on antipsychotic medication during pregnancy and if it affects babies,” said principal investigator Jayashri Kulkarni, PhD, director of the Monash Alfred Psychiatry Research Centre in Australia. “The lack of data has made it very difficult for clinicians to say anything conclusively on how safe it is for babies. This new research confirms that most babies are born healthy, but many experience neonatal problems, such as respiratory distress."

The study included Australian women who were taking antipsychotic drugs to treat one of several disorders, including schizophrenia, major depression, and bipolar disorder. Participants were recruited during pregnancy or within the first year of giving birth, and their treatment was managed by their usual clinical team. The research was conducted through in-person and telephone interviews. The study included women taking a number of different medications, including quetiapine, olanzapine, aripiprazole, risperidone, clozapine, and haloperidol.