Wang, Zixuan;
(2021)
The safety of antipsychotic use during pregnancy.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
Aim: To investigate the patterns of gestational antipsychotics use and whether exposure to antipsychotic medications in pregnancy is associated with gestational diabetes mellitus (GDM) in mothers and seizure, attention deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), preterm birth (PTB) and small for gestational age (SFGA) in subsequent children. Methods: Firstly, a methodological review was conducted to review the methodological characteristics of existing observational studies that investigate the association between prenatal central nervous system (CNS) drugs use and CNS disorders. Secondly, a systematic review and meta-analysis was conducted to evaluate the evidence-based association between gestational antipsychotic use and GDM. Thirdly, a cross-sectional study was conducted to investigate the patterns and trends of antipsychotics use during pregnancy in the United Kingdom (UK) and Hong Kong (HK). Lastly, seven cohort studies were conducted to investigate the association between antipsychotics use in pregnancy and the risk of above-mentioned outcomes, respectively. Results: 4.64% and 0.34% of pregnancies were prescribed at least one prescription of antipsychotic during pregnancy in the UK and HK, respectively. When women who continued using antipsychotics during pregnancy were compared with those who had stopped, there was no evidence to demonstrate an increased risk of GDM. No evidence supported prenatal exposure to antipsychotics can increase the risk of ADHD/ASD/SFGA. Children with prenatal antipsychotics exposure was associated with an increased risk of seizure (HR 1.49, 95% CI 1.11-1.99) and PTB (OR 1.40, 95%CI 1.13-1.75), comparing to those without. However, further sibling-matched analyses and negative control analyses indicated no evidence supported the above-mentioned associations. Conclusion: This PhD project did not suggest an increased risk of GDM in mothers or seizure/ADHD/ASD/PTB/SFGA in children regarding antipsychotics use during pregnancy. Women are not recommended to stop their regular antipsychotic prescription during pregnancy due to the risk of developing GDM or delivering an offspring with seizure/ADHD/ASD/PTB/SFGA.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | The safety of antipsychotic use during pregnancy |
| Event: | UCL (University College London) |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2021. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10140851 |
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