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Article: The use of antipsychotic agents during pregnancy and the risk of gestational diabetes mellitus: a systematic review and meta-analysis

TitleThe use of antipsychotic agents during pregnancy and the risk of gestational diabetes mellitus: a systematic review and meta-analysis
Authors
KeywordsAntipsychotics
gestational diabetes
pregnancy
Issue Date2020
PublisherCambridge University Press. The Journal's web site is located at http://journals.cambridge.org/action/displayJournal?jid=PSM
Citation
Psychological Medicine, 2020, Epub 2020-01-23 How to Cite?
AbstractBackground: Previous studies have found contradicting results with regard to the use of antipsychotics during pregnancy and the risk of gestational diabetes mellitus (GDM). We aimed to evaluate the association between antipsychotic use in pregnancy and GDM. Methods: A systematic literature search was conducted in PubMed, EMBASE, PsycINFO and Cochrane Library databases up to March 2019, for data from observational studies assessing the association between gestational antipsychotic use and GDM. Non-English studies, animal studies, case reports, conference abstracts, book chapters, reviews and summaries were excluded. The primary outcome was GDM. Estimates were pooled using a random effect model, with the I2 statistic used to estimate heterogeneity of results. Our study protocol was registered with PROSPERO number: CRD42018095014. Results: In total 10 cohort studies met the inclusion criteria in our systematic review with 6642 exposed and 1 860 290 unexposed pregnancies. Six studies were included in the meta-analysis with a pooled adjusted relative risk of 1.24 overall [95% confidence interval (CI) 1.09–1.42]. The I2 result suggested low heterogeneity between studies (I2 = 6.7%, p = 0.373). Conclusion: We found that the use of antipsychotic medications during pregnancy is associated with an increased risk of GDM in mothers. However, the evidence is still insufficient, especially for specific drug classes. We recommend more studies to investigate this association for specific drug classes, dosages and comorbidities to help clinicians to manage the risk of GDM if initiation or continuation of antipsychotic prescriptions during pregnancy is needed.
Persistent Identifierhttp://hdl.handle.net/10722/284940
ISSN
2019 Impact Factor: 5.813
2015 SCImago Journal Rankings: 2.843

 

DC FieldValueLanguage
dc.contributor.authorWang, Z-
dc.contributor.authorWong, ICK-
dc.contributor.authorMan, KKC-
dc.contributor.authorAlfageh, BH-
dc.contributor.authorMongkhon, P-
dc.contributor.authorBrauer, R-
dc.date.accessioned2020-08-07T09:04:38Z-
dc.date.available2020-08-07T09:04:38Z-
dc.date.issued2020-
dc.identifier.citationPsychological Medicine, 2020, Epub 2020-01-23-
dc.identifier.issn0033-2917-
dc.identifier.urihttp://hdl.handle.net/10722/284940-
dc.description.abstractBackground: Previous studies have found contradicting results with regard to the use of antipsychotics during pregnancy and the risk of gestational diabetes mellitus (GDM). We aimed to evaluate the association between antipsychotic use in pregnancy and GDM. Methods: A systematic literature search was conducted in PubMed, EMBASE, PsycINFO and Cochrane Library databases up to March 2019, for data from observational studies assessing the association between gestational antipsychotic use and GDM. Non-English studies, animal studies, case reports, conference abstracts, book chapters, reviews and summaries were excluded. The primary outcome was GDM. Estimates were pooled using a random effect model, with the I2 statistic used to estimate heterogeneity of results. Our study protocol was registered with PROSPERO number: CRD42018095014. Results: In total 10 cohort studies met the inclusion criteria in our systematic review with 6642 exposed and 1 860 290 unexposed pregnancies. Six studies were included in the meta-analysis with a pooled adjusted relative risk of 1.24 overall [95% confidence interval (CI) 1.09–1.42]. The I2 result suggested low heterogeneity between studies (I2 = 6.7%, p = 0.373). Conclusion: We found that the use of antipsychotic medications during pregnancy is associated with an increased risk of GDM in mothers. However, the evidence is still insufficient, especially for specific drug classes. We recommend more studies to investigate this association for specific drug classes, dosages and comorbidities to help clinicians to manage the risk of GDM if initiation or continuation of antipsychotic prescriptions during pregnancy is needed.-
dc.languageeng-
dc.publisherCambridge University Press. The Journal's web site is located at http://journals.cambridge.org/action/displayJournal?jid=PSM-
dc.relation.ispartofPsychological Medicine-
dc.rightsPsychological Medicine. Copyright © Cambridge University Press.-
dc.rightsThis article has been published in a revised form in [Journal] [http://doi.org/XXX]. This version is free to view and download for private research and study only. Not for re-distribution, re-sale or use in derivative works. © copyright holder.-
dc.subjectAntipsychotics-
dc.subjectgestational diabetes-
dc.subjectpregnancy-
dc.titleThe use of antipsychotic agents during pregnancy and the risk of gestational diabetes mellitus: a systematic review and meta-analysis-
dc.typeArticle-
dc.identifier.emailWong, ICK: wongick@hku.hk-
dc.identifier.emailMan, KKC: mkckth@hku.hk-
dc.identifier.authorityWong, ICK=rp01480-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1017/S003329171900401X-
dc.identifier.pmid31969198-
dc.identifier.scopuseid_2-s2.0-85078427877-
dc.identifier.hkuros311782-
dc.identifier.volumeEpub 2020-01-23-
dc.publisher.placeUnited Kingdom-

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