Safety of GLP-1 Receptor Agonists and Other Second-Line Antidiabetics in Early Pregnancy

JAMA Internal Medicine, Journal Year: 2023, Volume and Issue: 184(2), P. 144 - 144

Published: Dec. 11, 2023

Importance Increasing use of second-line noninsulin antidiabetic medication (ADM) in pregnant individuals with type 2 diabetes (T2D) may result fetal exposure, but their teratogenic risk is unknown. Objective To evaluate periconceptional ADMs and whether it associated increased major congenital malformations (MCMs) the infant. Design, Setting, Participants This observational population-based cohort study used data from 4 Nordic countries (2009-2020), US MarketScan Database (2012-2021), Israeli Maccabi Health Services database (2009-2020). Pregnant women T2D were identified live-born infants followed until up to 1 year after birth. Exposure Periconceptional exposure was defined as or more prescription fill sulfonylureas, dipeptidyl peptidase (DPP-4) inhibitors, glucagon-like peptide (GLP-1) receptor agonists, sodium-glucose cotransporter (SGLT2) insulin (active comparator) 90 days before pregnancy end first trimester. Main Outcomes Measures Relative risks (RRs) 95% CIs for MCMs estimated using log-binomial regression models, adjusting key confounders each meta-analyzed. Results differed between (32, 295, 73 per 100 000 pregnancies Nordics, US, Israel, respectively), over period, especially US. The standardized prevalence 3.7% all (n = 3 514 865), 5.3% born 51 826), among exposed sulfonylureas 9.7% 1362); DPP-4 6.1% 687); GLP-1 8.3% 938); SGLT2 7.0% 335); insulin, 7.8% 5078). Compared adjusted RRs 1.18 (95% CI, 0.94-1.48), 0.83 0.64-1.06), 0.95 0.72-1.26), 0.98 0.65-1.46) respectively. Conclusions Relevance Use rapidly increasing treatment other indications, resulting an number pregnancies. Although some estimates imprecise, results did not indicate a large above conferred by maternal requiring treatment. reassuring, confirmation studies needed, continuous monitoring will provide precise accumulate.

Language: Английский

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Antipsychotic use during pregnancy and outcomes in pregnant individuals and newborns

Journal of Affective Disorders, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 1, 2025

Language: Английский

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Mental Health Disorders in Pregnancy and the Early Postpartum

Published: Jan. 18, 2025

Mental health disorders are common in pregnancy and after childbirth with over 10% of women manifesting some form mental illness during this time. Maternity services will encounter symptoms that vary severity from mild self-limiting to potentially life-threatening. These conditions carry risks for both the woman fetus/newborn. Detecting with, or at risk of, a serious disorder enabling them access appropriate care timely fashion is shared responsibility. However, given frequency contact they have through period, maternity pivotal role. From perspective, high-risk pregnancies those primarily associated (psychotic illnesses, bipolar severe depressive episodes). Healthcare professionals caring pregnant should skills detect identify how specialist care.

Language: Английский

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Risk of congenital malformations associated with first-trimester exposure to antipsychotics: a propensity score-weighted population-based cohort study

European Psychiatry, Journal Year: 2024, Volume and Issue: 67(1)

Published: Jan. 1, 2024

Abstract Background There is growing concern regarding teratogenic effect of antipsychotics. Previous research assessing association between antipsychotics and congenital malformations (CMs) yielded mixed results were all derived from Western countries. We aimed to examine risk major organ/system-specific CMs associated with prenatal antipsychotic exposure in Hong Kong. Methods This population-based study identified women aged 15–50 years who delivered their first/singleton child 2003–2018 public healthcare service database. Propensity score (PS)-weighted logistic-regression analyses performed following first-trimester classes (second- first-generation antipsychotic; SGA FGA) six most frequently-prescribed individual Results Of 465,069 women, 419 420 redeemed ≥1 prescription FGA during first-trimester, respectively. Prevalence any was 4.9% (95%CI:4.9–5.0%) unexposed-infants, 9.1% (6.7–12.3%) SGA-exposed infants, 6.2% (4.3–9.0%) FGA-exposed infants. (adjusted-odds-ratio: 2.11 [95%CI:1.19–3.86]) increased CMs. finding consistent sensitivity addressing misclassification confounding by treatment indication, but not PS-matched analysis. Elevated observed infants exposed high-dose olanzapine (7.50 [1.65–36.13]) quetiapine (15.03 [4.86–56.72]), wide-CIs. Organ/system-specific SGA, or Conclusion a small consistently affirmed analyses, precluding firm conclusions. Research large sample size clarifying comparative safety on specific warranted.

Language: Английский

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In Memoriam—Helle Kieler (1956–2024)

Pharmacoepidemiology and Drug Safety, Journal Year: 2025, Volume and Issue: 34(1)

Published: Jan. 1, 2025

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Antipsychotic continuation during pregnancy and risk of postpartum relapse in women with schizophrenia: nationwide register-based study

The British Journal of Psychiatry, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 8

Published: Jan. 10, 2025

Background Women with schizophrenia frequently discontinue antipsychotic medications during pregnancy. However, evidence on the risk of postpartum relapse associated use pregnancy is lacking. Aims To investigate within-individual association between continuation and in women schizophrenia. Method This retrospective cohort study used data who gave live birth 2007 2018 identified from National Health Information Database South Korea. were classified according to patterns 12 months before delivery as non-users, discontinuers continuers. Relapse was defined admission for psychosis (ICD-10, F20–29). The incidence rate ratio (IRR) 6-month period estimated using conditional Poisson regression, reference set 2 1 years delivery. Additionally, we calculated relative ratios (RRRs) IRRs different patterns. Results Among 3026 included analysis (median age 34 years, interquartile range 31–37), 0.56 times (RRR, 95% CI 0.36–0.87) lower continuers (IRR = 1.31, 0.89–1.72) than 2.34, 1.87–2.91). discontinuers, did not change significantly timing discontinuation (trend P 0.946). Conclusions Antipsychotic a reduced Continuing antipsychotics would be recommended after risk–benefit assessment.

Language: Английский

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Maternal mental disorders, psychotropic drugs, socioeconomic status, and offspring congenital anomalies

Journal of International Medical Research, Journal Year: 2025, Volume and Issue: 53(1)

Published: Jan. 1, 2025

Objective To evaluate whether there is an association between maternal mental health, purchase of psychotropic drugs, socioeconomic status and major congenital anomalies in offspring. Methods A register-based cohort study 6189 Finnish primiparous women who had a singleton delivery 2009 2015. Data on pregnancy outcomes, psychiatric diagnosis, prescription drug purchases offspring were obtained from national registers. Results Severe depressive disorders diagnosed 2.0% severe anxiety 1.1%. During pregnancy, 9.6% purchased drugs. Of these women, 5.7% delivered with anomaly. Women drugs increased risk delivering child compared did not Multivariate regression analysis showed that benzodiazepines the (odds ratio 2.11 [95% confidence interval 1.17 to 3.81]). Pregnant purchasing more often lived alone smoked, higher body mass index, lower annual income educational attainment than Conclusions Benzodiazepine use, but status, may be associated abnormalities

Language: Английский

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Effects of Psychotropic Medications Taken by Pregnant Women on Newborn Medical Condition and Lactation Method

Neuropsychopharmacology Reports, Journal Year: 2025, Volume and Issue: 45(1)

Published: Jan. 30, 2025

ABSTRACT Background Maternal psychiatric condition during the perinatal period is relevant to children's cognitive development and mental health. Psychotropic medications are necessary maintain health of pregnant women with disorders, but they often avoided due concerns about adverse effects, such as congenital malformations abnormal neurodevelopment. A retrospective study disorders using psychotropic was performed clarify maternal child demographic data investigate whether affected Apgar score decision breastfeed. Methods Data who were referred from Department Obstetrics Gynecology Neuropsychiatry at Ehime University Hospital January 2014 December 2022 collected retrospectively. Pearson's chi‐squared test multiple regression analysis used for statistical analyses. Results total 226 included; 194 gave birth our hospital, whom 79 (40.7%) taking drugs time delivery. None children had malformations. There no relationship between use choice Multiple showed that only gestational weeks significantly associated weight ( p < 0.001) (1 min: = 0.030; 5 0.044). Conclusions The appears safe beneficial both their children, breastfeeding should be considered even if mother continues take medication. To these points, prospective studies large samples several countries needed.

Language: Английский

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Prescribing Patterns for the Treatment of Bipolar Disorder in Pregnancy: A Retrospective Cohort Study

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(5), P. 1638 - 1638

Published: Feb. 28, 2025

Background: Untreated bipolar disorder during pregnancy is associated with poor prenatal care, decreased fetal growth, and an increased risk for postnatal complications, including postpartum psychosis. Although mood stabilizers are first-line therapy, many patients providers discontinue them in early pregnancy. Antidepressants as monotherapy can increase the of mania rapid cycling, especially I, not recommended. Objective: This study aims to describe prescribing patterns pharmacologic management Methods: retrospective cohort included pregnant patients, ≥14 years old, a documented diagnosis ≥two clinic visits after 1 January 2014, who delivered by 31 October 2017, within our health system. Eligible were identified ICD-9 ICD-10 codes their medication profiles. The primary outcome was treatment regimens at first visit, pregnancy, delivery. Descriptive statistics used. Results: Of 214 pregnancies analyzed, 134 (62.6%) used psychiatric medications 79/134 (59%) being stabilizers. During initial 61/214 (28.5%) on medications, 30 (49.2%) 16 (26.2%) antidepressants alone. At delivery, 98/214 (45.8%) 48/98 (49%) 35/98 (35.7%) without Other therapies benzodiazepines, buspirone, amphetamines, or combination. Conclusions: Despite having disorder, only 30/214 (14%), 79/214 (36.9%), 48/214 (22.4%) treated respectively. Unfortunately, justification discontinuation documented. most commonly prescribed stabilizer lurasidone, followed lamotrigine. Antidepressant persisted throughout demonstrating inappropriate disease management.

Language: Английский

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How Early-Life Antipsychotic Drug Administration Modifies Behavioral and Brain Function in Adulthood

Current topics in behavioral neurosciences, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 1, 2025

Language: Английский

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