Evidence map›Paper›PMID 35220525›Full record

ArticleCNS drugs2022

Antipsychotic Use During Pregnancy and Risk for Gestational Diabetes: A National Register-Based Cohort Study in Sweden.

Essi Heinonen, Lisa Forsberg, Ulrika Nörby, Katarina Wide, Karin Källén

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

Article in CNS drugs, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 5 pooled it
6.2field-weighted citation impact, top 3% 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

17 citing papers in PubMed, 5 syntheses or guidelines pooled it, 37 citations in OpenAlex.

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

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Essi HeinonenDivision of Paediatrics, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, 14157, Stockholm, Sweden. essi.heinonen@ki.se.ORCID http://orcid.org/0000-0003-2107-0561
Lisa ForsbergDivision of Paediatrics, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, 14157, Stockholm, Sweden.
Ulrika NörbyDepartment of Clinical Sciences, Centre of Reproduction, Epidemiology, Tornblad Institute, Lund University, Lund, Sweden.
Katarina WideDivision of Paediatrics, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, 14157, Stockholm, Sweden.
Karin KällénDepartment of Clinical Sciences, Centre of Reproduction, Epidemiology, Tornblad Institute, Lund University, Lund, Sweden.
Karolinska University Hospital · SELund University · SEKarolinska Institutet · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveWe aimed to study whether antipsychotic use during pregnancy is associated with gestational diabetes.

methodsThis was a Swedish national register-based cohort study on the Medical Birth Register and the Prescribed Drug Register including all 1,307,487 singleton births between July 2006 and December 2017. Antipsychotics were divided into first-generation antipsychotics (n = 728), high-risk metabolic second-generation antipsychotics including olanzapine, clozapine and quetiapine (n = 1710), and other second-generation antipsychotics (n = 541). The risks for gestational diabetes, foetal growth disturbances, pre-eclampsia, caesarean section and preterm labour were assessed. Women treated during pregnancy were compared to women not treated during pregnancy and to women who used antipsychotics before/after but not during pregnancy.

resultsThe crude risk ratio for gestational diabetes for women treated with high-risk metabolic second-generation antipsychotics during pregnancy was 2.2 (95% confidence interval [CI] 1.6-2.9) compared to untreated pregnant women (n = 1,296,539) and 1.8 (95% CI 1.4-2.5) compared to women treated before/after pregnancy (n = 34,492). After adjustment for maternal factors including body mass index, the risk ratios were 1.8 (95% CI 1.3-2.4) and 1.6 (95% CI 1.2-2.1). Exposed infants had an increased risk of being large for gestational age: adjusted risk ratios 1.6 (95% CI 1.3-1.9) and 1.3 (95% CI 1.1-1.6) compared to no maternal antipsychotic use during pregnancy and maternal use before/after the pregnancy. Other antipsychotics were not associated with metabolic risks.

conclusionsOlanzapine, clozapine and quetiapine used during pregnancy were associated with increased risks for gestational diabetes and the infant being large for gestational age. Enhanced metabolic monitoring should be considered for pregnant women using these drugs.

Indexed as

Antipsychotic AgentsClozapineDiabetes, GestationalCesarean SectionCohort StudiesFemaleHumansInfant, NewbornOlanzapinePregnancyQuetiapine FumarateSwedenAntipsychotic AgentsClozapineOlanzapineQuetiapine Fumarate

Identifiers

PMID35220525
PMCPMC9095513
OpenAlexW4214608035

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

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.