Use of some antipsychotics during pregnancy may raise risk of gestational diabetes

May 7, 2018, American Psychiatric Association
Credit: CC0 Public Domain

Women who take certain antipsychotic medications and continue the use of these medications through pregnancy may be at increased risk for gestational diabetes, according to new research published online today by the American Journal of Psychiatry.

The authors, from Brigham and Women's Hospital, Harvard Medical School, Harvard School of Public Health and Massachusetts General Hospital, presented their findings at a media briefing in New York, where they had come to deliver a presentation at the Annual Meeting of the American Psychiatric Association (APA).

There is a well-established link between some and metabolic side effects, such as weight gain and diabetes, which are risk factors for gestational diabetes. Gestational diabetes, a complication of , can lead to problems including preeclampsia, cesarean delivery and neonatal hypoglycemia. An estimated 5 to 9 percent of women develop gestational diabetes during pregnancy. In addition, up to 50 percent of women with gestational diabetes later develop type 2 diabetes.

The researchers looked at the risk of developing gestational diabetes associated with continued use of several , including aripiprazole (Abilify), ziprasidone (Geodon), quetiapine (Seroquel), risperidone (Risperdal) and olanzapine (Zyprexa), during pregnancy.

The study involved a large group of women enrolled in Medicaid who were pregnant, did not have diabetes, and had been taking antipsychotic medication in the three months prior to pregnancy. They compared those who continued medication during pregnancy with those who stopped during pregnancy.

The study found that depending on the medication, the absolute risk of gestational diabetes among the study participants continuing medication was 4.2 percent to 12 percent; among those stopping medication during pregnancy it ranged from 3.8 percent to 4.7 percent.

For two of the five antipsychotic medications examined, olanzapine and quetiapine, there was an increased risk for gestational diabetes compared with women who discontinued these medications, after adjustment for potential confounding variables. There was not an increased risk of for women taking aripiprazole, ziprasidone and risperidone.

"It is important to consider alternative explanations for these findings," said study coauthor Krista F. Huybrechts, M.S., Ph.D., Associate Professor of Medicine, Brigham and Women's Hospital, Harvard Medical School. "The main concern is potential factors not captured fully in the data, particularly obesity. However, we demonstrated that the imbalance in the obesity prevalence between those continuing treatment and those discontinuing would have to be very high to fully explain the increased risk. This seems unlikely given that all were treated before the start of pregnancy and we accounted for a broad range of proxy variables."

The authors note that risk of is just one factor in a medication decision during pregnancy; other factors include the benefits of the medication and the risks of changing treatment. They suggest that further research on switching antipsychotic medications during pregnancy would help in the making treatment decisions.

Explore further: Get fit to cut your diabetes risk during pregnancy

More information: Yoonyoung Park et al, Continuation of Atypical Antipsychotic Medication During Early Pregnancy and the Risk of Gestational Diabetes, American Journal of Psychiatry (2018). DOI: 10.1176/appi.ajp.2018.17040393

Related Stories

Get fit to cut your diabetes risk during pregnancy

April 27, 2018
(HealthDay)—If she's fit, a woman is less likely to develop diabetes during pregnancy, a new study contends.

Better fitness in pre-pregnant women linked with less risk of gestational diabetes

April 2, 2018
Expectant mothers who were more fit before pregnancy are at lower risk of developing gestational diabetes, according to a new study from the University of Iowa.

Metformin lowers risk of late miscarriage, preterm birth in pregnant women with PCOS

March 20, 2018
The oral diabetes medication metformin seems to reduce the chance of a late miscarriage and premature birth among women with polycystic ovary syndrome (PCOS) but does not affect their rate of developing gestational diabetes, ...

Antipsychotic drug use in pregnant women appears to pose minimal risk, new study suggests

May 13, 2015
Antipsychotic medication use during pregnancy does not put women at additional risk of developing gestational diabetes, hypertensive disorders or major blood clots that obstruct circulation, according to a new study led by ...

Diabetes, but not diabetes drug, linked to poor pregnancy outcomes

December 20, 2017
New research indicates that pregnant women with pre-gestational diabetes who take metformin are at a higher risk for adverse pregnancy outcomes—such as major birth defects and pregnancy loss—than the general population, ...

A history of kidney stones may contribute to certain complications during pregnancy

November 5, 2017
Results from a new study suggest that a history of kidney stones may indicate an increased risk for metabolic and hypertensive complications during pregnancy and add support to a growing body of research linking kidney stones ...

Recommended for you

Researchers show that category learning can be influenced by where an object is in our field of vision

August 15, 2018
We humans are pros at category learning—the process by which we classify things, whether objects, concepts or events, into groups that share certain features that are relevant to us. We do it when we distinguish friends ...

Male tobacco smokers have brain-wide reduction of CB1 receptors

August 15, 2018
Chronic, frequent tobacco smokers have a decreased number of cannabinoid CB1 receptors, the "pot receptor", when compared with non-smokers, reports a study in Biological Psychiatry.

Unwanted or unplanned babies likely have more troubled close relationships

August 15, 2018
Findings appearing in the Journal of Social and Personal Relationships show people who believe they resulted from unwanted or unplanned pregnancies tend to have more insecure relationship styles as adults.

Researchers link animosity in couples to inflammation, bacteria in bloodstream

August 15, 2018
Married people who fight nastily are more likely to suffer from leaky guts—a problem that unleashes bacteria into the blood and can drive up disease-causing inflammation, new research suggests.

How we explain the behavior of others depends on our beliefs about their 'true selves'

August 14, 2018
Why did they do that? It's a question we ask every day in attempting to understand the behavior of others and make meaning of the world around us. How we answer the question, however, varies depending on our moral attitudes ...

The science behind rooting for the home team

August 14, 2018
Young children often observe society dividing its members—by ethnicity, religion, gender, or even favorite sports team. But a review by a Yale psychologist published August 14 in the journal Trends in Cognitive Sciences ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.