Antipsychotic medications are effective in treating some mental illnesses and are commonly used to treat mental disorders such as schizophrenia and bipolar disorder. In women, pregnancy can increase the risk of psychiatric disorders, such as postpartum mood disorders. Women with severe mental disorders may need antipsychotic medications during childbearing years, or even during pregnancy, to reduce symptoms in acute episodes and to prevent a relapse in terms of psychotic symptoms in stable patients. Antipsychotic medications can cross the placenta and reach the unborn child and may cause unintended harm on newborn development. However, there is little information on the safety of antipsychotics in pregnancy, in particular potential central nervous system (CNS) disorders in children, such as attention-deficit hyperactivity disorder (ADHD), autism spectrum disorders (ASD) and non-febrile seizures. Thus, we plan to conduct a study using CPRD data to find out whether taking antipsychotics in pregnancy will increase the chance of children being diagnosed with either ADHD, ASD or non-febrile seizures. We hypothesise that there is no link between prenatal antipsychotics use in pregnancy and CNS disorders.
The aim of the study is to assess the association between prenatal exposure to antipsychotics and the risk of central nervous system (CNS) disorders including attention-deficit hyperactivity disorder (ADHD), autism spectrum disorders (ASD), and non-febrile seizure/epilepsy in children. We will compare the rate of 1) ADHD, 2) ASD, and 3) non-febrile seizure/epilepsy in the offspring of mothers who used antipsychotics during pregnancy with a) the rate in offspring whose mothers never used antipsychotics; b) the rate in offspring whose mothers who stopped their treatment with antipsychotics before conception; c) the rate in offspring of mothers with a psychiatric diagnosis who were never exposed to antipsychotics; and d) the rate in offspring whose mothers took antidepressant drugs during pregnancy. Associations between the exposure status for each trimester and outcomes will be evaluated using Cox proportional hazard regression model to estimate the hazard ratios. Robust standard error will be used to adjust for data clustering. Propensity Scores will be used to adjust for general covariates. Sibling-matched analyses will be conducted to control for shared genetic and social confounding.
Attention-deficit hyperactivity disorder (ADHD), autism spectrum disorders (ASD), and non-febrile seizure/epilepsy in children.
Ian Wong - Chief Investigator - University College London ( UCL )
Zixuan Wang - Corresponding Applicant - University College London ( UCL )
- Collaborator -
Hind Khalifeh - Collaborator - King's College London (KCL)
Kenneth Man - Collaborator - University College London ( UCL )
Li Wei - Collaborator - University College London ( UCL )
Ruth Brauer - Collaborator - University College London ( UCL )
Stephen Weng - Collaborator - University of Nottingham
CPRD Mother-Baby Link;HES Admitted Patient Care;Patient Level Index of Multiple Deprivation;Pregnancy Register