Abstract
This study aims to estimate the prevalence of and temporal trends in prenatal antipsychotic medication use within a cohort of pregnant women in the U.S. We identified live born deliveries to women aged 15–45 years in 2001–2007 from 11 U.S. health plans participating in the Medication Exposure in Pregnancy Risk Evaluation Program. We ascertained prenatal exposure to antipsychotics from health plan pharmacy dispensing files, gestational age from linked infant birth certificate files, and ICD-9-CM diagnosis codes from health plan claims files. We calculated the prevalence of prenatal use of atypical and typical antipsychotics according to year of delivery, trimester of pregnancy, and mental health diagnosis. Among 585,615 qualifying deliveries, 4,223 (0.72 %) were to women who received an atypical antipsychotic and 548 (0.09 %) were to women receiving a typical antipsychotic any time from 60 days before pregnancy through delivery. There was a 2.5-fold increase in atypical antipsychotic use during the study period, from 0.33 % (95 % confidence interval: 0.29 %, 0.37 %) in 2001 to 0.82 % (0.76 %, 0.88 %) in 2007, while the use of typical antipsychotics remained stable. Depression was the most common mental health diagnosis among deliveries to women with atypical antipsychotic use (63 %), followed by bipolar disorder (43 %) and schizophrenia (13 %). The number and proportion of pregnancies exposed to atypical antipsychotics has increased dramatically in recent years. Studies are needed to examine the comparative safety and effectiveness of these medications relative to other therapeutic options in pregnancy.
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Acknowledgments
This study was supported through funding from contracts HHSF223200510012C, HHSF223200510009C, and HHSF223200510008C from the U.S. Food and Drug Administration (Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, Silver Spring, MD, USA). Dr. Dublin was supported by National Institute on Aging grant K23AG028954, Dr. Bobo was supported by National Institute of Mental Health grant K23MH087747. Dr. Andrade has received research funding from GlaxoSmithKline, a manufacturer of an antipsychotic medication, in the past 12 months for a project unrelated to antipsychotic medication use. The views expressed in this paper are those of the authors and are not intended to convey official U.S. Food and Drug Administration policy or guidance. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Aging, National Institute of Mental Health, or the National Institutes of Health.
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Toh, S., Li, Q., Cheetham, T.C. et al. Prevalence and trends in the use of antipsychotic medications during pregnancy in the U.S., 2001–2007: a population-based study of 585,615 deliveries. Arch Womens Ment Health 16, 149–157 (2013). https://doi.org/10.1007/s00737-013-0330-6
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DOI: https://doi.org/10.1007/s00737-013-0330-6