Skip to main content
SpringerLink
Log in

Maternal Use of Antipsychotics or Neuroleptics and Infant Congenital Malformations

  • Chapter
  • First Online:
Maternal Drug Use and Infant Congenital Malformations

  • 396 Accesses

Abstract

Many studies have been published on the teratogenic property of antipsychotic drugs but most of them are small and the results vary between studies. There are some evidence that these drugs may have a weak teratogenic effect, perhaps stronger for typical than for atypical antipsychotics. In the Swedish data presented, there are indications of a specifically high risk with thioxanthene derivatives but this finding needs verification from an independent material. If possible, avoidance of these drugs in early pregnancy can be recommended but if exposure has occurred, the teratogenic risk is not so high that an interruption of the pregnancy is reasonable. The question on the teratogenic effect of lithium (especially on cardiovascular defects) is still open and if possible lithium should be avoided during the first trimester.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Bellet F, Beyens MN, Bernard N, Beghin D, Elefant E, Vial T. Exposure to aripirazole during embryogenesis: a prospective multicenter cohort study. Pharmacoepidemiol Drug Saf. 2015;24:368–80.

    Article  CAS  Google Scholar 

  • Bodén R, Lundgren M, Brandt L, Reutfors J, Andersen M, Kieler H. Risks of adverse pregnancy and birth outcomes in women treated or not treated with mood stabilisers for bipolar disorder: population-based cohort study. BMJ. 2012;345:e7085. https://doi.org/10.1136/bmj.e7085.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Cohen LS, Viguera AC, NcInerney K, Freeman MP, Sosinsky AZ, Moustafa D, Marfurt SP, Kwiatkowski MA, Murphy SK, Farrell AM, Chitayatr D, Hernández-Diaz S. Reproductive safety of second-generation antipsychotics: current data from the Massachusetts General Hospital National Pregnancy Registry for atypical antipsychotics. Am J Psychiatry. 2016;173:263–70.

    Article  Google Scholar 

  • Coppola D, Russo LJ, Kwarta RF Jr, Varughese R, Schmider J. Evaluating the postmarketing experience of risperidone use during pregnancy and neonatal outcomes. Drug Saf. 2007;30:247–64.

    Article  CAS  Google Scholar 

  • Coughlin CG, Blackwell KA, Bartley C, Hay M, Yonkers KA, Bloch MH. Obstetric and neonatal outcomes after antipsychotic medication exposure in pregnancy. Obstet Gynecol. 2015;125:1224–35.

    Article  CAS  Google Scholar 

  • Diav-Citrin O, Schechtman S, Ornoy S, Arnon J, Schaefer C, Garbis H, Clementi M, Ornoy A. Safety of haloperidol and penfluridol in pregnancy: a multicenter, prospective, controlled study. J Clin Psychiatry. 2005;66:317–22.

    Article  CAS  Google Scholar 

  • Diav-Citrin O, Shechtman S, Tahover E, Finkel Pekarsky V, Arnon J, Kennedy D, Erebara A, Einarson A, Ornoy A. Pregnancy outcome following in utero exposure to lithium; a prospective, comparative, observational study. Am J Psychiatry. 2014;171:785–94.

    Article  Google Scholar 

  • Haberman F, Fritzsche J, Fuhlbrück F, Wacker E, Allignol A, Weber-Schoendorfer C, Meister R, Schaefer C. Atypical antipsychotic drugs and pregnancy outcome. A prospective, cohort study. J Clin Psychopharmacol. 2013;33:453–62.

    Article  Google Scholar 

  • Heinonen OP, Slone D, Shapiro S. Birth defects and drugs in pregnancy. Littleton, MA: Publishing Sciences Group; 1977.

    Google Scholar 

  • Huybrechts KF, Hernández-Diaz S, Patorno E, Desai RJ, Mogun H, Dejene SZ, Cohen JM, Panchaud A, Cohen L, Baterman BT. Antipsychotic use in pregnancy and the risk for congenital malformations. JAMA Psychiatry. 2016;73:938–46.

    Article  Google Scholar 

  • Jablensky AV, Morgan V, Zubricj SR, Bower C, Yellachich L-A. Pregnancy, delivery and neonatal complications in a population cohort of women with schizophrenia and major affective disorders. Am J Psychiatry. 2005;162:79–91.

    Article  Google Scholar 

  • Jacobsson SJ, Jones K, Johnson K, Ceolin L, Kaur P, Sahn D, Donnenfeld AE, Rieder M, Santelli R, Smythe J, Pastuzak A, Einarson T, Koren G. Prospective multicenter study of pregnancy outcome after lithium exposure during first trimester. Lancet. 1992;339:530–3.

    Article  Google Scholar 

  • Källén B. Comments on teratogen update: lithium. Teratology. 1988;38:597.

    Article  Google Scholar 

  • Källén B, Tandberg A. Lithium and pregnancy. A cohort study of manic-depressive women. Acta Psychiatr Scand. 1983;68:134–9.

    Article  Google Scholar 

  • Källén B, Borg N, Reis M. The use of central nervous system active drugs during pregnancy. Pharmaceuticals. 2013;6:1221–86.

    Article  Google Scholar 

  • Kulkarni J, Worsley R, Gilbert H, Gavrilidis E, Van Rheenen TE, Wang W, McCauley K, Fitzgerald P. A prospective cohort study of antipsychotic medications in pregnancy: the first 147 pregnancies and 100 one year old babies. PLoS One. 2014;9:e94788. https://doi.org/10.1371/journal.pone.0094788.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • McKenna K, Koren G, Tetelbaum M, Wilton L, Shakir S, Diav-Citrin O, Levinson A, Zipursky RB, Einarson A. Pregnancy utcome of women using atypical antipsychotic drugs: a prospective comparative study. J Clin Psychiatry. 2005;66:444–9.

    Article  CAS  Google Scholar 

  • Moriarty AJ, Nance MR. Trifluoperazine and pregnancy. Letter to the editor. Can Med Assoc J. 1968;88:375–6.

    Google Scholar 

  • Nora J, Nora AH, Toews WH. Lithium, Ebstein’s anomaly, and other congenital heart defects. Lancet. 1974;2:594–5.

    Article  CAS  Google Scholar 

  • Onken M, Mick I, Schaefer C. Paliperidone and pregnancy—an evaluation of the German Embryotox database. Arch Womens Ment Health. 2018;21(6):657–62. https://doi.org/10.1007/s00737-018-0828.z.

    Article  PubMed  Google Scholar 

  • Patorno E, Huybrechts KE, Bateman BT, Cohen JM, Desai RJ, Mogun H, Cohen LS, Hernández-Diaz S. Lithium use in pregnancy and the risk of cardiac malformations. N Engl J Med. 2017;376:2245–54.

    Article  CAS  Google Scholar 

  • Petersen I, Sammon CJ, McCrea RL, Osborn DPJ, Evans SJ, Cowen PJ, Nazareth I. Risks associated with antipsychotic treatment in pregnancy. Comparative cohort studies based on electronic health records. Schizophr Res. 2016;176:349–56.

    Article  Google Scholar 

  • Reis M, Källén B. Maternal use of antipsychotics in early pregnancy and delivery outcome. J Clin Psychopharmacol. 2008;28:279–88.

    Article  CAS  Google Scholar 

  • Rumeau-Rouquette C, Goujard J, Huel G. Possible teratogenic effect on phenothiazines in human beings. Teratology. 1977;15:57–64.

    Article  CAS  Google Scholar 

  • Sadowski A, Todorow M, Brojeni PY, Koren G, Nulman I. Pregnancy outcomes following maternal exposure to second-generation antipsychotics given with other psychotropic drugs: a cohort study. BMJ Open. 2013;3:e003062. https://doi.org/10.1136/bmjopen-2013-003062.

    Article  PubMed  PubMed Central  Google Scholar 

  • Schou M, Amdisen A. Lithium teratogenicity. Lancet. 1971;1:1132.

    Article  CAS  Google Scholar 

  • Shin YJ, Choi JS, Ahn HK, Ryu HM, Kim MY, Han JY. Pregnancy outcome in women reporting ingestion of levosipiride in early pregnancy. J Obstet Gynaecol. 2017;37:982–5.

    Article  Google Scholar 

  • Slone D, Siskind V, Heinonen OP, Monson RR, Kaufman DW, Shapiro S. Antenatal exposure to the phenothiazines in relation to congenital malformations, perinatal mortality rate, birth weight, and intelligence quotient score. Am J Obstet Gynecol. 1977;128:486–8.

    Article  CAS  Google Scholar 

  • Zalzstein E, Koren G, Einarson T, Freedom RM. A case-control study on the association between first trimester exposure to lithium and Ebstein’s anomaly. Am J Cardiol. 1990;65:817–8.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Tornblad Institute for Comparative Embryology, Lund University, Lund, Sweden

    Bengt Källén

Authors
  1. Bengt Källén
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Källén, B. (2019). Maternal Use of Antipsychotics or Neuroleptics and Infant Congenital Malformations. In: Maternal Drug Use and Infant Congenital Malformations. Springer, Cham. https://doi.org/10.1007/978-3-030-17898-7_25

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-17898-7_25

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-17897-0

  • Online ISBN: 978-3-030-17898-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation