In Utero Antipsychotic Exposure May Not Up Neurodevelopmental Disorder Risk

THURSDAY, March 31, 2022 (HealthDay News) -- In utero exposure to commonly prescribed antipsychotic medications does not seem to meaningfully increase the risk for neurodevelopmental disorders (NDD) in offspring, according to a study published online March 28 in JAMA Internal Medicine.

Loreen Straub, M.D., from Brigham and Women's Hospital in Boston, and colleagues examined whether children prenatally exposed to antipsychotic medications have an increased risk for NDD using data from the Medicaid Analytic eXtract (MAX, 2000 to 2014) and the IBM Health MarketScan Research Database (MarketScan, 2003 to 2015) for publicly and privately insured mother-child dyads. The MAX cohort included 2,034,883 children who were not and 9,551 children who were prenatally exposed to antipsychotic medications; the MarketScan included 1,306,408 and 1,221 children, respectively.

The researchers found that the unadjusted results were consistent with an approximately twofold increased risk for most exposure-outcome contrasts; however, after adjustment for confounding variables, the risks were no longer meaningfully increased (pooled unadjusted versus adjusted hazard ratios [95 percent confidence interval] for any NDD after any antipsychotic exposure: 1.91 [1.79 to 2.03] versus 1.08 [1.01 to 1.17]); aripiprazole was a possible exception (adjusted hazard ratio, 1.36; 95 percent confidence interval, 1.14 to 1.63). Across sensitivity analyses, the results were consistent.

"These findings provide much needed clarity regarding NDD risk and may help to inform treatment decision making in pregnancy, which is a sophisticated trade-off between benefits and risks," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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