Increasing use of atypical antipsychotics and anticonvulsants during pregnancy†
Article first published online: 5 NOV 2012
Copyright © 2012 John Wiley & Sons, Ltd.
Pharmacoepidemiology and Drug Safety
Volume 22, Issue 7, pages 794–801, July 2013
How to Cite
Epstein, R. A., Bobo, W. V., Shelton, R. C., Arbogast, P. G., Morrow, J. A., Wang, W., Chandrasekhar, R. and Cooper, W. O. (2013), Increasing use of atypical antipsychotics and anticonvulsants during pregnancy. Pharmacoepidem. Drug Safe., 22: 794–801. doi: 10.1002/pds.3366
The work in this manuscript was postered at the Building Interdisciplinary Research Careers in Women's Health (BIRCWH) Scholars Meeting and 7th Annual Interdisciplinary Women's Health Research Symposium, Washington, D. C., November 8–9, 2010, and at the 28th International Conference on Pharmacoepidemiology and Therapeutic Risk Management, Barcelona, Spain, August 23-26, 2012.
- Issue published online: 3 JUL 2013
- Article first published online: 5 NOV 2012
- Manuscript Accepted: 5 OCT 2012
- Manuscript Revised: 2 OCT 2012
- Manuscript Received: 6 DEC 2011
- National Institute of Child Health and Human Development. Grant Number: 5 K12 HD 043483-09
- fetal effects;
To quantify maternal use of atypical antipsychotics, typical antipsychotics, anticonvulsants, and lithium during pregnancy.
Tennessee birth and death records were linked to Tennessee Medicaid data to conduct a retrospective cohort study of 296 817 women enrolled in Tennessee Medicaid throughout pregnancy who had a live birth or fetal death from 1985 to 2005.
During the study time period, the adjusted rate of use of any study medication during pregnancy increased from nearly 14 to 31 per 1000 pregnancies (β = 0.08, 95% CI = 0.07, 0.09). Significant increases were reported in use of anticonvulsants alone among mothers with pain and other psychiatric disorders, atypical antipsychotics alone among mothers with bipolar disorders, schizophrenia, unipolar depressive disorders, and other psychiatric disorders, and more than one studied medication for mothers with epilepsy, pain disorders, bipolar disorders, unipolar depressive disorders, and other psychiatric disorders. Significant decreases were reported in use of lithium alone and typical antipsychotics alone for all clinically meaningful diagnosis groups.
There was a substantial increase in use of atypical antipsychotics alone, anticonvulsants alone, and medications from multiple studied categories among Tennessee Medicaid-insured pregnant women during the study period. Further examination of the maternal and fetal consequences of exposure to these medications during pregnancy is warranted. Copyright © 2012 John Wiley & Sons, Ltd.