Neonatal outcomes after in utero exposure to antipsychotics: a systematic review and meta-analysis.

Autor: Joseph-Delaffon K; Département de Santé Publique, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Trousseau, Centre de Référence sur les Agents Tératogènes (CRAT), Paris, F75012, France., Eletri L; Department of Neonatology, Centre Hospitalier du Mans, Le Mans, 72037, France., Dechartres A; Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Unité de Recherche Clinique PSL-CFX, AP-HP, Hôpital Pitié Salpêtrière, Paris, CIC-1901, 75013, France., Nordeng HME; PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway.; Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway., Richardson JL; UK Teratology Information Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Health Security Agency, Newcastle upon Tyne, UK., Elefant E; Département de Santé Publique, AP-HP. Sorbonne Université, Hôpital Trousseau, Centre de Référence sur les Agents Tératogènes (CRAT), Paris, F75012, France., Mitanchez D; Department of Neonatology, Bretonneau Hospital, François Rabelais University, Tours, F-37000, France. delphine.mitanchez@univ-tours.fr.; INSERM UMR_S 938 Centre de Recherche Saint Antoine, Paris, F-75012, France. delphine.mitanchez@univ-tours.fr., Marin B; Département de Santé Publique, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Trousseau, Centre de Référence sur les Agents Tératogènes (CRAT), Paris, F75012, France.
Jazyk: angličtina
Zdroj: European journal of epidemiology [Eur J Epidemiol] 2024 Oct 01. Date of Electronic Publication: 2024 Oct 01.
DOI: 10.1007/s10654-024-01156-y
Abstrakt: Adverse neonatal outcomes following in utero antipsychotic exposure remain unclear. This systematic review and meta-analysis aimed to investigate associations between in utero first- and second-generation antipsychotic exposure and various neonatal outcomes. The primary outcome was small for gestational age. Secondary outcomes included other birth weight-related measures, prematurity and neonatal outcomes. MEDLINE, EMBASE, CENTRAL, ICTRP, and ClinicalTrials.gov were searched for on 8th July 2023. Two reviewers independently selected studies reporting associations between exposure and neonatal outcomes (all designs were eligible, no language or time restriction) and extracted data. ROBINS-I was used for risk of bias assessment. Meta-analyses were performed. Measures of association were odds ratios and mean differences. Thirty-one observational studies were included. Regarding small for gestational age < 10th percentile, meta-analysis was only performed for second-generation antipsychotics and showed no evidence for an association (OR 1.31 [95%CI 0.83; 2.07]; I²=46%; p het =0.13, n = 4 studies). First-generation antipsychotics were associated with an increased risk of small for gestational age < 3rd percentile (OR 1.37 [95%CI 1.02; 1.83]; I²=60%; p het =0.04, n = 5) and a lower mean birthweight (MD -135 g [95%CI -203; -66]; I²=53%; p het =0.07, n = 5). Second-generation antipsychotics were associated with large for gestational age > 97th percentile (OR 1.56 [95%CI 1.31; 1.87]; I²=4%; p het =0.37, n = 4) and Apgar score < 7 (OR 1.64 [95%CI 1.09; 2.47]; I²=47%; p het =0.13, n = 4). Both types of antipsychotics were associated with increased risks of preterm birth and neonatal hospitalization. Despite potential confounding in the studies, this systematic review and meta-analysis showed that newborns of mothers using antipsychotics during pregnancy are potentially at risk of adverse neonatal outcomes. Data sources: MEDLINE, EMBASE, CENTRAL, ICTRP, ClinicalTrials.gov. Prospero Registration Number CRD42023401805.
(© 2024. Springer Nature B.V.)
Databáze: MEDLINE
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