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Second-Generation Antipsychotics and Pregnancy Complications

Julkaistu 3.11.2019



To study if second-generation antipsychotic (S-GA) use during pregnancy is associated with an increased risk of pregnancy and neonatal complications.


A population-based birth cohort study using national register data extracted from the "Drugs and Pregnancy" database in Finland, years 1996-2016. The sampling frame included 1,181,090 pregnant women and their singleton births. Women were categorized into three groups: exposed to S-GAs during pregnancy (n = 4225), exposed to first-generation antipsychotics (F-GAs) during pregnancy (n = 1576), and unexposed (no purchases of S-GAs or F-GAs during pregnancy, n = 21,125). Pregnancy outcomes in S-GA users were compared with those in the two comparison groups using multiple logistic regression models.


Comparing S-GA users with unexposed ones, the risk was increased for gestational diabetes (adjusted odds ratio, OR 1.43; 95% CI 1.25-1.65), cesarean section (OR 1.35; 95% CI 1.18-1.53), being born large for gestational age (LGA) (OR 1.57; 95% CI 1.14-2.16), and preterm birth (OR 1.29; 95% CI 1.03-1.62). The risk for these outcomes increased further with continuous S-GA use. Infants in the S-GA group were also more likely to suffer from neonatal complications. Comparing S-GA users with the F-GA group, the risk of cesarean section and LGA was higher (OR 1.25, 95% CI 1.03-1.51; and OR 1.89, 95% CI 1.20-2.99, respectively). Neonatal complications did not differ between the S-GA and F-GA groups.


Prenatal exposure to S-GAs is associated with an increased risk of pregnancy complications related to impaired glucose metabolism. Neonatal problems are common and occur similarly in S-GA and F-GA users.

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Maria Ellfolk, Maarit K. Leinonen, Mika Gissler, Anna Lahesmaa-Korpinen, Leena Saastamoinen, Marja-Leena Nurminen, Heli Malm

Lisätietoja julkaisusta

  • Vertaisarvioitu: kyllä.
  • Avoin saatavuus: kyllä.
  • Koko viite: Ellfolk, M., Leinonen, M. K., Gissler, M., Lahesmaa-Korpinen, A. M., Saastamoinen, L., Nurminen, M. L., & Malm, H. (2020). Second-generation antipsychotics and pregnancy complications. European journal of clinical pharmacology, 76(1), 107–115.

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