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

Sengwee Toh, Qian Li, T. Craig Cheetham, William O. Cooper, Robert Davis, Sascha Dublin, Tarek A. Hammad, De Kun Li, Pamala A. Pawloski, Simone P. Pinheiro, Marsha A. Raebel, Pamela E. Scott, David H. Smith, William V. Bobo, Jean M. Lawrence, Inna Dashevsky, Katherine Haffenreffer, Lyndsay A. Avalos, Susan E. Andrade

Research output: Contribution to journalArticle

62 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)149-157
Number of pages9
JournalArchives of Women's Mental Health
Volume16
Issue number2
DOIs
StatePublished - Apr 1 2013

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Antipsychotic Agents
Pregnancy
Population
Mental Health
Health
Pregnancy Trimesters
Birth Certificates
Program Evaluation
International Classification of Diseases
Bipolar Disorder
Gestational Age
Pregnant Women
Schizophrenia
Confidence Intervals
Depression
Safety

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynecology
  • Psychiatry and Mental health

Cite this

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. / Toh, Sengwee; Li, Qian; Cheetham, T. Craig; Cooper, William O.; Davis, Robert; Dublin, Sascha; Hammad, Tarek A.; Li, De Kun; Pawloski, Pamala A.; Pinheiro, Simone P.; Raebel, Marsha A.; Scott, Pamela E.; Smith, David H.; Bobo, William V.; Lawrence, Jean M.; Dashevsky, Inna; Haffenreffer, Katherine; Avalos, Lyndsay A.; Andrade, Susan E.

In: Archives of Women's Mental Health, Vol. 16, No. 2, 01.04.2013, p. 149-157.

Research output: Contribution to journalArticle

Toh, S, Li, Q, Cheetham, TC, Cooper, WO, Davis, R, Dublin, S, Hammad, TA, Li, DK, Pawloski, PA, Pinheiro, SP, Raebel, MA, Scott, PE, Smith, DH, Bobo, WV, Lawrence, JM, Dashevsky, I, Haffenreffer, K, Avalos, LA & Andrade, SE 2013, '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', Archives of Women's Mental Health, vol. 16, no. 2, pp. 149-157. https://doi.org/10.1007/s00737-013-0330-6
Toh, Sengwee ; Li, Qian ; Cheetham, T. Craig ; Cooper, William O. ; Davis, Robert ; Dublin, Sascha ; Hammad, Tarek A. ; Li, De Kun ; Pawloski, Pamala A. ; Pinheiro, Simone P. ; Raebel, Marsha A. ; Scott, Pamela E. ; Smith, David H. ; Bobo, William V. ; Lawrence, Jean M. ; Dashevsky, Inna ; Haffenreffer, Katherine ; Avalos, Lyndsay A. ; Andrade, Susan E. / 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. In: Archives of Women's Mental Health. 2013 ; Vol. 16, No. 2. pp. 149-157.
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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.",
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