Abstract
Objective
This study aims to investigate the developmental effects of atypical antipsychotics on infants who were born to mothers taking an atypical antipsychotic throughout pregnancy.
Method
The developmental progress of 76 infants who experienced fetal exposure to atypical antipsychotics was compared to that of 76 matched control infants who had no fetal exposure to any antipsychotics. Planned assessment included Apgar score, body weight, height, and the cognitive, language, motor, social–emotional, and adaptive behavior composite scores of the Bayley Scales of Infant and Toddler Development, third edition (BSID-III). Student’s t test and Chi-square analysis were used as appropriate. Repeated measurements were evaluated by analysis of covariance.
Results
At 2 months of age, the mean composite scores of cognitive, motor, social–emotional, and adaptive behavior of BSID-III were significantly lower in atypical antipsychotic-exposed infants than the controls. More atypical antipsychotic-exposed infants had delayed development in cognitive, motor, social–emotional, and adaptive behavior domains as defined by the composite score of <85 in these subscales of BSID-III. At 12 months of age, there were no significant differences between the two groups in all mean composite scores of BSID-III. More atypical antipsychotic-exposed infants had low birth weight than the controls (13.2 vs. 2.6 %, P = 0.031), although there were no significant difference in mean birth weight and height between the two groups.
Conclusion
Fetal exposure to atypical antipsychotics may cause short-term delayed development in cognitive, motor, social–emotional, and adaptive behavior, but not in language, body weight, or height.
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American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington, DC
Apgar V (1953) A proposal for a new method of evaluation of the newborn infant. Curr Res Anesth Analg 32(4):260–267
Bayley N (2005) Bayley scales of infant and toddler development, 3rd edn. Psychological Corporation, San Antonio, TX
Duran A, Ugur MM, Turan S, Emul M (2008) Clozapine use in two women with schizophrenia during pregnancy. J Psychopharmacol 22(1):111–113
Feng YJ, Sheng Q (2010) Textbook of obstetrics & gynecology, 2nd edn. People’s Medical, Beijing
First MB, Spitzer RL, Gibbon M (1997) Structured clinical interview for DSM-IV Axis I Disorders-Clinician Version (SCID-CV). American Psychiatry, Washington, DC
Gassó P, Mas S, Molina O, Bernardo M, Lafuente A, Parellada E (2012) Neurotoxic/neuroprotective activity of haloperidol, risperidone and paliperidone in neuroblastoma cells. Prog Neuropsychopharmacol Biol Psychiatry 36(1):71–77
Gupta N, Grover S (2004) Safety of clozapine in 2 successive pregnancies. Can J Psychiatry 49(12):863
Hong J, Windmeijer F, Novick D, Haro JM, Brown J (2009) The cost of relapse in patients with schizophrenia in the European SOHO (Schizophrenia Outpatient Health Outcomes) study. Prog Neuropsychopharmacol Biol Psychiatry 33(5):835–841
Johnson KC, LaPrairie JL, Brennan PA, Stowe ZN, Newport DJ (2012) Prenatal antipsychotic exposure and neuromotor performance during infancy. Arch Gen Psychiatry 69(8):787–94
Lin HC, Chen IJ, Chen YH, Lee HC, Wu FJ (2010) Maternal schizophrenia and pregnancy outcome: does the use of antipsychotics make a difference? Schizophr Res 116(1):55–60
Lindenmayer JP, Liu-Seifert H, Kulkarni PM, Kinon BJ, Stauffer V, Edwards SE, Chen L, Adams DH, Ascher-Svanum H, Buckley PF, Citrome L, Volavka J (2009) Medication nonadherence and treatment outcome in patients with schizophrenia or schizoaffective disorder with suboptimal prior response. J Clin Psychiatry 70(7):990–996
Makrides M, Gibson RA, McPhee AJ, Yelland L, Quinlivan J, Ryan P, DOMInO Investigative Team (2010) Effect of DHA supplementation during pregnancy on maternal depression and neurodevelopment of young children: a randomized controlled trial. JAMA 304(15):1675–1683
McKenna K, Koren G, Tetelbaum M, Wilton L, Shakir S, Diav-Citrin O, Levinson A, Zipursky RB, Einarson A (2005) Pregnancy outcome of women using atypical antipsychotic drugs: a prospective comparative study. J Clin Psychiatry 66(4):444–49, quiz 546
Mendhekar DN (2007) Possible delayed speech acquisition with clozapine therapy during pregnancy and lactation. J Neuropsychiatry Clin Neurosci 19(2):196–197
Msall ME (2010) Measuring outcomes after extreme prematurity with the Bayley-III scales of infant and toddler development: a cautionary tale from Australia. Arch Pediatr Adolesc Med 164(4):391–393
Mucklow JC (1986) The fate of drugs in pregnancy. Clin Obstet Gynaecol 13(2):161–175
Newham JJ, Thomas SH, MacRitchie K, McElhatton PR, McAllister-Williams RH (2008) Birth weight of infants after maternal exposure to typical and atypical antipsychotics: prospective comparison study. Br J Psychiatry 192(5):333–337
Park SW, Phuong VT, Lee CH, Lee JG, Seo MK, Cho HY, Fang ZH, Lee BJ, Kim YH (2011) Effects of antipsychotic drugs on BDNF, GSK-3β, and β-catenin expression in rats subjected to immobilization stress. Neurosci Res 71(4):335–340
Robertson CM, Hendson L, Biggs WS, Acton BV (2010) Application of the Flynn effect for the Bayley III scales. Arch Pediatr Adolesc Med 164(11):1072–1073
Slone D, Siskind V, Heinonen OP, Monson RR, Kaufman DW, Shapiro S (1977) Antenatal exposure to the phenothiazines in relation to congenital malformations, perinatal mortality rate, birth weight, and intelligence quotient score. Am J Obstet Gynecol 128(5):486–488
Wang M (2010) Textbook of paediatrics, 5th edn. People’s Medical, Beijing
Weiden PJ, Olfson M (1995) Cost of relapse in schizophrenia. Schizophr Bull 21(3):419–429
Wichman CL (2009) Atypical antipsychotic use in pregnancy: a retrospective review. Arch Womens Ment Health 12(1):53–57
Wirshing DA, Boyd JA, Meng LR, Ballon JS, Marder SR, Wirshing WC (2002) The effects of novel antipsychotics on glucose and lipid levels. J Clin Psychiatry 63(10):856–865
Wu RR, Zhao JP, Liu ZN et al (2006) Effects of typical and atypical antipsychotics on glucose-insulin homeostasis and lipid metabolism in first-episode schizophrenia. Psychopharmacology (Berl) 186(4):572–578
Wunderink L, Nienhuis FJ, Sytema S, Slooff CJ, Knegtering R, Wiersma D (2007) Guided discontinuation versus maintenance treatment in remitted first-episode psychosis: relapse rates and functional outcome. J Clin Psychiatry 68(5):654–661
Acknowledgments
Dr. Wu expresses her gratitude to the World Psychiatric Association for providing financial support for her fellowship.
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Dr. Wu is a World Psychiatry Association Visiting Scholar in the Mood Disorders Program of Department Psychiatry at Case Western Reserve University/University Hospitals Case Medical Center, Cleveland, OH, USA.
ClinicalTrials.gov Identifier: NCT01479400
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Peng, M., Gao, K., Ding, Y. et al. Effects of prenatal exposure to atypical antipsychotics on postnatal development and growth of infants: a case-controlled, prospective study. Psychopharmacology 228, 577–584 (2013). https://doi.org/10.1007/s00213-013-3060-6
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DOI: https://doi.org/10.1007/s00213-013-3060-6