Association between Congenital Malformations and Second-Generation Antipsychotic Use in Pregnant Women: A Nationwide Cohort Study in Korea

2021 ◽  
Author(s):  
Jinhee Lee ◽  
Boung Chul Lee ◽  
Gi Hyeon Seo
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Congenital Malformations ◽  
Second Generation ◽  
Second Generation Antipsychotic

scholarly journals Second-generation antipsychotic use during pregnancy and risk of congenital malformations

2021 ◽  
Author(s):  
Maria Ellfolk ◽  
Maarit K. Leinonen ◽  
Mika Gissler ◽  
Sonja Kiuru-Kuhlefelt ◽  
Leena Saastamoinen ◽  
...  
Keyword(s):  
Congenital Malformations ◽  
Second Generation ◽  
First Trimester ◽  
Population Based ◽  
Birth Cohort Study ◽  
Sampling Frame ◽  
Logistic Regression Models ◽  
Increased Risk ◽  
Second Generation Antipsychotic ◽  
Major Congenital Malformations

Abstract Purpose To study if second-generation antipsychotic (S-GA) use during the first trimester of pregnancy is associated with an increased risk of major congenital malformations (MCM). Methods A population-based birth cohort study using national register data extracted from the Drugs and Pregnancy database in Finland, years 1996–2017. The sampling frame included 1,273,987 pregnant women. We included singleton pregnancies ending in live or stillbirth or termination of pregnancy due to severe malformation. Pregnancies with exposure to known teratogens were excluded. Women were categorized into three groups: exposed to S-GAs (n = 3478), exposed to first-generation antipsychotics (F-GAs) (n = 1030), and unexposed (no purchases of S-GAs or F-GAs during pregnancy, n = 22,540). We excluded genetic conditions and compared the prevalence of MCMs in S-GA users to the two comparison groups using multiple logistic regression models. Results Use of S-GAs during early pregnancy was not associated with an increased risk of overall MCMs compared to unexposed (adjusted odds ratio, OR 0.92; 95% CI 0.72–1.19) or to F-GA users (OR 0.82; 95% CI 0.56–1.20). Of individual S-GAs, olanzapine use was associated with an increased risk of overall MCMs (OR 2.12; 95% CI 1.19–3.76), and specifically, an increased risk of musculoskeletal malformations (OR 3.71; 95% CI 1.35–10.1) when compared to unexposed, while comparisons to F-GA users did not show significant results. Conclusions Olanzapine use is associated with an increased risk of major congenital malformations and specifically, musculoskeletal malformations. Use during pregnancy should be restricted to situations where no safer alternatives exist.

Second-Generation Antipsychotic Use in Children and Adolescents: A Six-Month Prospective Cohort Study in Drug-Naïve Patients

2014 ◽  
Vol 53 (11) ◽  
pp. 1179-1190.e4 ◽  
Author(s):  
Celso Arango ◽  
Miriam Giráldez ◽  
Jessica Merchán-Naranjo ◽  
Inmaculada Baeza ◽  
Josefina Castro-Fornieles ◽  
...  
Keyword(s):  
Cohort Study ◽  
Children And Adolescents ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Second Generation ◽  
Drug Naïve ◽  
Second Generation Antipsychotic

scholarly journals Caribbean Consortium for Research in Environmental and Occupational Health (CCREOH) Cohort Study: influences of complex environmental exposures on maternal and child health in Suriname

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e034702
Author(s):  
Wilco Zijlmans ◽  
Jeffrey Wickliffe ◽  
Ashna Hindori-Mohangoo ◽  
Sigrid MacDonald-Ottevanger ◽  
Paul Ouboter ◽  
...  
Keyword(s):  
Cohort Study ◽  
Occupational Health ◽  
Pregnant Women ◽  
Fish Consumption ◽  
Depression Scale ◽  
Environmental Exposures ◽  
International Standards ◽  
Long Term Effects ◽  
The Impact ◽  
Environmental And Occupational Health

PurposeThe Caribbean Consortium for Research in Environmental and Occupational Health prospective environmental epidemiologic cohort study addresses the impact of chemical and non-chemical environmental exposures on mother/child dyads in Suriname. The study determines associations between levels of environmental elements and toxicants in pregnant women, and birth outcomes and neurodevelopment in their children.ParticipantsPregnant women (N=1143) were enrolled from December 2016 to July 2019 from three regions of Suriname: Paramaribo (N=738), Nickerie (N=204) and the tropical rainforest interior (N=201). Infants (N=992) were enrolled at birth. Follow-up will take place until children are 48 months old.Findings to dateBiospecimens and questionnaire data on physiological and psychosocial health in pregnant women have been analysed. 39.1% had hair mercury (Hg) levels exceeding values considered safe by international standards. Median hair Hg concentrations in women from Paramaribo (N=522) were 0.64 µg/g hair (IQRs 0.36–1.09; range 0.00–7.12), from Nickerie (N=176) 0.73 µg/g (IQR 0.45–1.05; range 0.00–5.79) and the interior (N=178) 3.48 µg/g (IQR 1.92–7.39; range 0.38–18.20). 96.1% of women ate fish, respective consumption of the three most consumed carnivorous species, Hoplias aimara, Serrasalmus rhombeus and Cichla ocellaris, known to have high Hg levels, was 44.4%, 19.3% and 26.3%, respectively, and was greater among the interior subcohort. 89% frequently consumed the vegetable tannia, samples of which showed presence of worldwide banned pesticides. 24.9% of pregnant women had Edinburgh Depression Scale scores indicative of probable depression.Future plansFish consumption advisories are in development, especially relevant to interior women for whom fish consumption is likely to be the primary source of Hg exposure. Effects of potentially beneficial neuroprotective factors in fish that may counter neurotoxic effects of Hg are being examined. A pesticide literacy assessment in pregnant women is in progress. Neurodevelopmental assessments and telomere length measurements of the children to evaluate long-term effects of prenatal exposures to toxicant mixtures are ongoing.

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