eprintid: 10088170 rev_number: 25 eprint_status: archive userid: 608 dir: disk0/10/08/81/70 datestamp: 2019-12-17 10:30:51 lastmod: 2021-09-18 21:52:16 status_changed: 2019-12-17 10:30:51 type: article metadata_visibility: show creators_name: Wang, Z creators_name: Wong, I creators_name: Man, K creators_name: Alfageh, B creators_name: Mongkhon, P creators_name: Brauer, R title: The use of antipsychotic agents during pregnancy and the risk of gestational diabetes mellitus: A systematic review and meta-analysis ispublished: inpress divisions: UCL divisions: B02 divisions: C08 divisions: D10 divisions: G11 note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. abstract: Background: Previous studies have found contradicting results with regard to the use of antipsychotics during pregnancy and the risk of gestational diabetes mellitus (GDM). We aimed to evaluate the association between antipsychotic use in pregnancy and GDM. Methods: A systematic literature search was conducted in PubMed, EMBASE, PsycINFO and Cochrane Library databases up to March 2019, for data from observational studies assessing the association between gestational antipsychotic use and GDM. Non-English studies, animal studies, case reports, conference abstracts, book chapters, reviews and summaries were excluded. The primary outcome was GDM. Estimates were pooled using a random effect model, with the I2 statistic used to estimate heterogeneity of results. Our study protocol was registered with PROSPERO number: CRD42018095014. Results: In total 10 cohort studies met the inclusion criteria in our systematic review with 6642 exposed and 1 860 290 unexposed pregnancies. Six studies were included in the meta-analysis with a pooled adjusted relative risk of 1.24 overall [95% confidence interval (CI) 1.09–1.42]. The I2 result suggested low heterogeneity between studies (I2 = 6.7%, p = 0.373). Conclusion: We found that the use of antipsychotic medications during pregnancy is associated with an increased risk of GDM in mothers. However, the evidence is still insufficient, especially for specific drug classes. We recommend more studies to investigate this association for specific drug classes, dosages and comorbidities to help clinicians to manage the risk of GDM if initiation or continuation of antipsychotic prescriptions during pregnancy is needed. date: 2020 date_type: published publisher: Cambridge University Press official_url: https://doi.org/10.1017/S003329171900401X oa_status: green full_text_type: other language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1731858 doi: 10.1017/S003329171900401X lyricists_name: Alfageh, Basmah lyricists_name: Brauer, Ruth lyricists_name: Man, Keng lyricists_name: Wang, Zixuan lyricists_name: Wong, Ian lyricists_id: BALFA13 lyricists_id: RBRAU10 lyricists_id: KCKMA73 lyricists_id: ZWANC79 lyricists_id: ICKWO00 actors_name: Man, Keng actors_name: Allington-Smith, Dominic actors_id: KCKMA73 actors_id: DAALL44 actors_role: owner actors_role: impersonator full_text_status: public publication: Psychological Medicine citation: Wang, Z; Wong, I; Man, K; Alfageh, B; Mongkhon, P; Brauer, R; (2020) The use of antipsychotic agents during pregnancy and the risk of gestational diabetes mellitus: A systematic review and meta-analysis. Psychological Medicine 10.1017/S003329171900401X <https://doi.org/10.1017/S003329171900401X>. (In press). Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10088170/1/Man_Manuscript%20Revision2.pdf