Evidence map›Paper›PMID 29730938›Full record

ArticleThe American journal of psychiatry2018

Continuation of Atypical Antipsychotic Medication During Early Pregnancy and the Risk of Gestational Diabetes.

Yoonyoung Park, Sonia Hernandez-Diaz, Brian T Bateman, Jacqueline M Cohen, Rishi J Desai, Elisabetta Patorno, Robert J Glynn, Lee S Cohen, Helen Mogun, Krista F Huybrechts

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The American journal of psychiatry, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 4 pooled it
9.6field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 4 syntheses or guidelines pooled it, 88 citations in OpenAlex.

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  14. Striking the Balance: Bipolar Disorder in the Perinatal Period.Focus (American Psychiatric Publishing) · 2024
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Yoonyoung ParkFrom the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston; the Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston; the Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston; and the Perinatal and Reproductive Psychiatry Program, Center for Women's Mental Health, Massachusetts General Hospital, Boston.
Sonia Hernandez-DiazFrom the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston; the Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston; the Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston; and the Perinatal and Reproductive Psychiatry Program, Center for Women's Mental Health, Massachusetts General Hospital, Boston.
Brian T BatemanFrom the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston; the Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston; the Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston; and the Perinatal and Reproductive Psychiatry Program, Center for Women's Mental Health, Massachusetts General Hospital, Boston.
Jacqueline M CohenFrom the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston; the Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston; the Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston; and the Perinatal and Reproductive Psychiatry Program, Center for Women's Mental Health, Massachusetts General Hospital, Boston.
Rishi J DesaiFrom the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston; the Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston; the Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston; and the Perinatal and Reproductive Psychiatry Program, Center for Women's Mental Health, Massachusetts General Hospital, Boston.
Elisabetta PatornoFrom the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston; the Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston; the Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston; and the Perinatal and Reproductive Psychiatry Program, Center for Women's Mental Health, Massachusetts General Hospital, Boston.
Robert J GlynnFrom the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston; the Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston; the Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston; and the Perinatal and Reproductive Psychiatry Program, Center for Women's Mental Health, Massachusetts General Hospital, Boston.
Lee S CohenFrom the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston; the Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston; the Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston; and the Perinatal and Reproductive Psychiatry Program, Center for Women's Mental Health, Massachusetts General Hospital, Boston.
Helen MogunFrom the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston; the Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston; the Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston; and the Perinatal and Reproductive Psychiatry Program, Center for Women's Mental Health, Massachusetts General Hospital, Boston.
Krista F HuybrechtsFrom the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston; the Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston; the Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston; and the Perinatal and Reproductive Psychiatry Program, Center for Women's Mental Health, Massachusetts General Hospital, Boston.
Brigham and Women's Hospital · US

Funding

Comparative Safety of commonly prescribed Psychotropic Drugs in pregnant WomenR01MH100216 · NIMH · HARVARD SCHOOL OF PUBLIC HEALTH · PI HERNANDEZ-DIAZ, SONIA · 2014 to 2016
$1.4M
Improved methods to assess the comparative safety of new psychiatric medicationsK01MH099141 · NIMH · BRIGHAM AND WOMEN'S HOSPITAL · PI HUYBRECHTS, KRISTA F · 2013 to 2017
$882k
Comparative safety & effectiveness of antihypertensive medications in pregnancyK08HD075831 · NICHD · BRIGHAM AND WOMEN'S HOSPITAL · PI BATEMAN, BRIAN THOMAS · 2013 to 2017
$717k
Novel Approaches to Monitor the Safety and Effectiveness of Newly Marketed Diabetes Medications in Older Adults Considering Frailty and MultimorbidityK08AG055670 · NIA · BRIGHAM AND WOMEN'S HOSPITAL · PI PATORNO, ELISABETTA · 2018 to 2021
$661k
NIA NIH HHS K08 AG055670NICHD NIH HHS K08 HD075831NIMH NIH HHS K01 MH099141NIMH NIH HHS R01 MH100216
6 · The paper itself

Abstract

objectiveSome atypical antipsychotics are associated with metabolic side effects, which are risk factors for gestational diabetes. The authors examined the risk of developing gestational diabetes associated with the continuation of treatment with aripiprazole, ziprasidone, quetiapine, risperidone, and olanzapine during pregnancy compared with discontinuation of these antipsychotic drugs.

methodNondiabetic pregnant women who were linked to a live-born infant and enrolled in Medicaid (2000-2010) and who received one or more prescriptions dispensed for an antipsychotic drug during the 3 months before pregnancy were included in the analyses. Among 1,543,334 pregnancies, some expectant mothers at baseline were receiving treatment with aripiprazole (N=1,924), ziprasidone (N=673), quetiapine (N=4,533), risperidone (N=1,824), or olanzapine (N=1,425). For each antipsychotic drug, women with two or more dispensings ("continuers") were compared with women with no dispensings ("discontinuers") during the first half of pregnancy. A generalized linear model and propensity-score stratification were used to obtain absolute and relative risks of developing gestational diabetes, with adjustment for confounders.

resultsWomen who continued antipsychotic treatment during pregnancy generally had higher comorbidity and longer baseline antipsychotic use. The crude risk of developing gestational diabetes among continuers compared with discontinuers, respectively, was 4.8% and 4.5% for aripiprazole, 4.2% and 3.8% for ziprasidone, 7.1% and 4.1% for quetiapine, 6.4% and 4.1% for risperidone, and 12.0% and 4.7% for olanzapine. The adjusted relative risks were 0.82 (95% CI=0.50-1.33) for aripiprazole, 0.76 (95% CI=0.29-2.00) for ziprasidone, 1.28 (95% CI=1.01-1.62) for quetiapine, 1.09 (95% CI=0.70-1.70) for risperidone, and 1.61 (95% CI=1.13-2.29) for olanzapine.

conclusionsCompared with women who discontinued use of an atypical antipsychotic medication before the start of pregnancy, women who continued treatment with olanzapine or quetiapine had an increased risk of gestational diabetes that may be explained by the metabolic effects associated with these two drugs.

Indexed as

AdultAntipsychotic AgentsAripiprazoleDiabetes, GestationalFemaleHumansOlanzapinePiperazinesPregnancyPregnancy ComplicationsPsychotic DisordersQuetiapine FumarateRisk FactorsRisperidoneThiazolesYoung AdultAntipsychotic AgentsAripiprazoleOlanzapinePiperazinesQuetiapine FumarateRisperidoneThiazolesziprasidoneAntipsychoticsDrug Side Effects-OtherWomen

Identifiers

PMID29730938
PMCPMC5988929
OpenAlexW2801381076

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.