title: 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.
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.
authors: Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA. darrentoh@post.harvard.edu
authors: Sengwee
authors: S
authors: Toh
authors: Qian
authors: Q
authors: Li
authors: T Craig
authors: TC
authors: Cheetham
authors: William O
authors: WO
authors: Cooper
authors: Robert L
authors: RL
authors: Davis
authors: Sascha
authors: S
authors: Dublin
authors: Tarek A
authors: TA
authors: Hammad
authors: De-Kun
authors: DK
authors: Li
authors: Pamala A
authors: PA
authors: Pawloski
authors: Simone P
authors: SP
authors: Pinheiro
authors: Marsha A
authors: MA
authors: Raebel
authors: Pamela E
authors: PE
authors: Scott
authors: David H
authors: DH
authors: Smith
authors: William V
authors: WV
authors: Bobo
authors: Jean M
authors: JM
authors: Lawrence
authors: Inna
authors: I
authors: Dashevsky
authors: Katherine
authors: K
authors: Haffenreffer
authors: Lyndsay A
authors: LA
authors: Avalos
authors: Susan E
authors: SE
authors: Andrade
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D004363:Drug Utilization / Q000706:statistics & numerical data / Q000639:trends*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D038801:International Classification of Diseases; D008875:Middle Aged; D011159:Population Surveillance; D011247:Pregnancy; D011295:Prenatal Care; D055656:Prescriptions / Q000706:statistics & numerical data*; D015995:Prevalence; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents
references: Obstet Gynecol. 2009 Sep;114(3):703-713
references: 19701065
references: Arch Gen Psychiatry. 2012 Jul;69(7):715-21
references: 22752236
references: J Clin Psychopharmacol. 2010 Jun;30(3):331-2
references: 20473073
references: Psychol Med. 2005 Jun;35(6):855-63
references: 15997605
references: Arch Gen Psychiatry. 2012 Aug;69(8):787-94
references: 22474072
references: Biol Psychiatry. 2007 Jul 15;62(2):107-14
references: 17306773
references: Drug Saf. 2000 Mar;22(3):195-214
references: 10738844
references: Pharmacoepidemiol Drug Saf. 2013 May;22(5):524-32
references: 23335117
references: J Clin Psychopharmacol. 2008 Jun;28(3):279-88
references: 18480684
references: Drugs. 2005;65(9):1193-206
references: 15916447
references: Am J Psychiatry. 2009 Sep;166(9):980-91
references: 19687129
references: Matern Child Health J. 2012 Oct;16(7):1349-54
references: 22002179
references: J Clin Psychiatry. 2005 Apr;66(4):444-9; quiz 546
references: 15816786
references: Am J Psychiatry. 2007 Aug;164(8):1214-20
references: 17671284
references: Br J Psychiatry. 2008 May;192(5):333-7
references: 18450655
references: Drug Saf. 2007;30(3):247-64
references: 17343431
references: Natl Vital Stat Rep. 2010 Aug 9;58(24):1-85
references: 21254725
references: Obstet Gynecol. 2008 Apr;111(4):1001-20
references: 18378767
references: Am J Psychiatry. 2004 Apr;161(4):608-20
references: 15056503
references: Am J Psychiatry. 1996 May;153(5):592-606
references: 8615404
references: Pharmacoepidemiol Drug Saf. 2013 Jul;22(7):794-801
references: 23124892
references: Arch Gen Psychiatry. 2005 Jun;62(6):593-602
references: 15939837
references: Pharmacoepidemiol Drug Saf. 2011 Feb;20(2):177-84
references: 21254289
references: Indian J Med Res. 2006 Apr;123(4):497-512
references: 16783040
references: Arch Womens Ment Health. 2009 Feb;12(1):53-7
references: 19137446
references: Am J Psychiatry. 2004 Feb;161(2 Suppl):1-56
references: 15000267
references: Am J Epidemiol. 2008 Mar 15;167(6):633-40
references: 18194999
references: N Engl J Med. 2006 Jun 8;354(23):2443-51
references: 16760444
references: Br J Clin Pharmacol. 2008 May;65(5):653-60
references: 18294334
references: Schizophr Bull. 2010 May;36(3):518-44
references: 18787227
references: Acta Psychiatr Scand. 2010 Jan;121(1):4-10
references: 20059452
references: Health Technol Assess. 2003;7(13):1-193
references: 12925268
references: Can J Psychiatry. 2002 Jun;47(5):426-36
references: 12085677
references: J Clin Psychiatry. 2002;63 Suppl 4:42-55
references: 11913676
references: Acta Psychiatr Scand Suppl. 2000;401:3-38
references: 10887978