{"title":"孕期接触非典型抗精神病药物与流产风险之间的关系。","authors":"Tomofumi Ishikawa, Takamasa Sakai, Noriyuki Iwama, Ryo Obara, Kei Morishita, Motohiko Adomi, Aoi Noda, Mami Ishikuro, Saya Kikuchi, Natsuko Kobayashi, Hiroaki Tomita, Masatoshi Saito, Hidekazu Nishigori, Shinichi Kuriyama, Nariyasu Mano, Taku Obara","doi":"10.1111/acps.13755","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>To evaluate the association between exposure to atypical antipsychotics during pregnancy and risk of miscarriage.</p>\n </section>\n \n <section>\n \n <h3> Material and Methods</h3>\n \n <p>This nested case–control study used a large Japanese administrative database. Pregnancy onset and outcomes were estimated using previously reported algorithms, classifying cases as women becoming pregnant between 2013 and 2022 and ending in a miscarriage. Controls were randomly selected from the entire pregnancy cohort by risk-set sampling with replacement and were individually matched to the cases (3:1). The association between exposure to atypical antipsychotics and risk of miscarriage was assessed using conditional logistic regression adjusted for confounders. The association between benzodiazepine exposure and the risk of miscarriage was assessed as a positive control.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>In the cohort, 44,118 patients were matched with 132,317 controls. The mean ages (standard deviations) of the case and control groups were 33.3 (5.7) and 33.2 (5.5) years, respectively. The prevalence of atypical antipsychotics was 0.5% in both groups. Aripiprazole is an individual antipsychotic with the highest prescription prevalence. The adjusted odds ratios (aOR) for miscarriage were 0.966 (95% confidence interval [CI], 0.796–1.173) for atypical antipsychotics and 0.998 (0.784–1.269) for aripiprazole. A higher aOR (1.431, 95% CI 1.303–1.573) suggested an association with benzodiazepines. A sensitivity analysis that limited the population to women diagnosed with schizophrenia alone did not suggest an association between atypical antipsychotics and the risk of miscarriage.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>The results of this study do not suggest an association between exposure to atypical antipsychotics during pregnancy and the risk of miscarriage.</p>\n </section>\n </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"150 6","pages":"562-572"},"PeriodicalIF":5.3000,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association between exposure to atypical antipsychotics during pregnancy and risk of miscarriage\",\"authors\":\"Tomofumi Ishikawa, Takamasa Sakai, Noriyuki Iwama, Ryo Obara, Kei Morishita, Motohiko Adomi, Aoi Noda, Mami Ishikuro, Saya Kikuchi, Natsuko Kobayashi, Hiroaki Tomita, Masatoshi Saito, Hidekazu Nishigori, Shinichi Kuriyama, Nariyasu Mano, Taku Obara\",\"doi\":\"10.1111/acps.13755\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>To evaluate the association between exposure to atypical antipsychotics during pregnancy and risk of miscarriage.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Material and Methods</h3>\\n \\n <p>This nested case–control study used a large Japanese administrative database. Pregnancy onset and outcomes were estimated using previously reported algorithms, classifying cases as women becoming pregnant between 2013 and 2022 and ending in a miscarriage. Controls were randomly selected from the entire pregnancy cohort by risk-set sampling with replacement and were individually matched to the cases (3:1). The association between exposure to atypical antipsychotics and risk of miscarriage was assessed using conditional logistic regression adjusted for confounders. The association between benzodiazepine exposure and the risk of miscarriage was assessed as a positive control.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>In the cohort, 44,118 patients were matched with 132,317 controls. The mean ages (standard deviations) of the case and control groups were 33.3 (5.7) and 33.2 (5.5) years, respectively. The prevalence of atypical antipsychotics was 0.5% in both groups. Aripiprazole is an individual antipsychotic with the highest prescription prevalence. The adjusted odds ratios (aOR) for miscarriage were 0.966 (95% confidence interval [CI], 0.796–1.173) for atypical antipsychotics and 0.998 (0.784–1.269) for aripiprazole. A higher aOR (1.431, 95% CI 1.303–1.573) suggested an association with benzodiazepines. A sensitivity analysis that limited the population to women diagnosed with schizophrenia alone did not suggest an association between atypical antipsychotics and the risk of miscarriage.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>The results of this study do not suggest an association between exposure to atypical antipsychotics during pregnancy and the risk of miscarriage.</p>\\n </section>\\n </div>\",\"PeriodicalId\":108,\"journal\":{\"name\":\"Acta Psychiatrica Scandinavica\",\"volume\":\"150 6\",\"pages\":\"562-572\"},\"PeriodicalIF\":5.3000,\"publicationDate\":\"2024-09-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta Psychiatrica Scandinavica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/acps.13755\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Psychiatrica Scandinavica","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/acps.13755","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Association between exposure to atypical antipsychotics during pregnancy and risk of miscarriage
Objective
To evaluate the association between exposure to atypical antipsychotics during pregnancy and risk of miscarriage.
Material and Methods
This nested case–control study used a large Japanese administrative database. Pregnancy onset and outcomes were estimated using previously reported algorithms, classifying cases as women becoming pregnant between 2013 and 2022 and ending in a miscarriage. Controls were randomly selected from the entire pregnancy cohort by risk-set sampling with replacement and were individually matched to the cases (3:1). The association between exposure to atypical antipsychotics and risk of miscarriage was assessed using conditional logistic regression adjusted for confounders. The association between benzodiazepine exposure and the risk of miscarriage was assessed as a positive control.
Results
In the cohort, 44,118 patients were matched with 132,317 controls. The mean ages (standard deviations) of the case and control groups were 33.3 (5.7) and 33.2 (5.5) years, respectively. The prevalence of atypical antipsychotics was 0.5% in both groups. Aripiprazole is an individual antipsychotic with the highest prescription prevalence. The adjusted odds ratios (aOR) for miscarriage were 0.966 (95% confidence interval [CI], 0.796–1.173) for atypical antipsychotics and 0.998 (0.784–1.269) for aripiprazole. A higher aOR (1.431, 95% CI 1.303–1.573) suggested an association with benzodiazepines. A sensitivity analysis that limited the population to women diagnosed with schizophrenia alone did not suggest an association between atypical antipsychotics and the risk of miscarriage.
Conclusions
The results of this study do not suggest an association between exposure to atypical antipsychotics during pregnancy and the risk of miscarriage.
期刊介绍：
Acta Psychiatrica Scandinavica acts as an international forum for the dissemination of information advancing the science and practice of psychiatry. In particular we focus on communicating frontline research to clinical psychiatrists and psychiatric researchers.
Acta Psychiatrica Scandinavica has traditionally been and remains a journal focusing predominantly on clinical psychiatry, but translational psychiatry is a topic of growing importance to our readers. Therefore, the journal welcomes submission of manuscripts based on both clinical- and more translational (e.g. preclinical and epidemiological) research. When preparing manuscripts based on translational studies for submission to Acta Psychiatrica Scandinavica, the authors should place emphasis on the clinical significance of the research question and the findings. Manuscripts based solely on preclinical research (e.g. animal models) are normally not considered for publication in the Journal.
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