Schizophrenia Research 116 (2010) 55–60

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Schizophrenia Research
j o u r n a l h o m e p a g e : w w w. e l s ev i e r. c o m / l o c a t e / s c h r e s

Maternal schizophrenia and pregnancy outcome: Does the use of

antipsychotics make a difference?
Herng-Ching Lin a,⁎, I-Ju Chen a,b, Yi-Hua Chen c, Hsin-Chien Lee d, Fang-Jen Wu e
a
School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
b
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
c
School of Public Health, Taipei Medical University, Taipei, Taiwan
d
School of Medicine, Department of Psychiatry, Taipei Medical University, Taipei, Taiwan
e
College of Pharmacy, Taipei Medical University, Taipei, Taiwan

a r t i c l e i n f o a b s t r a c t

Article history: Objective: This study compared the risk of adverse pregnancy outcome—including preterm births,
Received 25 July 2009 low birth weight (LBW), large-gestational-age (LGA), and small-gestational-age (SGA)—among
Received in revised form 13 October 2009 mothers with schizophrenia receiving typical, atypical, and no antipsychotics during pregnancy.
Accepted 18 October 2009 They were all compared with control subjects.
Available online 5 November 2009
Methods: We used population-based data from the Taiwan National Health Insurance Research
Database and birth certificate registry covering the years 2001 to 2003. In total, 696 mothers with
Keywords:
schizophrenia and 3480 matched unaffected mothers were included for analysis. After adjusting
Schizophrenia
for characteristics of mother, father, and infants, multivariate logistic regression analyses were
Antipsychotics
Pregnancy outcome performed to examine the risk of LBW, preterm gestation, SGA, and LGA, comparing mothers with
schizophrenia and unaffected mothers.
Results: After adjusting for potential confounders, the odds of LBW and SGA for unaffected mothers
respectively were 0.72 (95% CI = 0.50–0.88) and 0.81 (95% CI = 0.64–0.92) times those of mothers
with schizophrenia who had not receiving antipsychotics during pregnancy. There was no
significant difference in the risk of LBW, preterm births, LGA, and SGA babies compared to mothers
with schizophrenia receiving atypical antipsychotics during pregnancy and those not receiving
antipsychotics. However, mothers with schizophrenia receiving typical antipsychotics during
pregnancy had higher odds of preterm birth (OR = 2.46, 95% CI = 1.50–4.11) compared to those
not receiving antipsychotics.
Conclusions: The data suggest that the risks for LBW and SGA among mothers with schizophrenia
are not affected by antipsychotic use. Women who receive treatment with typical antipsychotics
during pregnancy are at slightly higher risk of preterm birth.
© 2009 Elsevier B.V. All rights reserved.

1. Introduction
The effect of antipsychotics on pregnant women has drawn
much attention during the past few years. In terms of pregnancy
outcome for women with schizophrenia however, the safety of
antipsychotics remains unclear. Pregnant women with schizo-
phrenia who discontinue antipsychotics are more likely to
⁎ Corresponding author. School of Health Care Administration, Taipei Medical
University, 250 Wu-Hsing St., Taipei 110, Taiwan. Tel.: +886 2 2736 1661x3613;
fax: +886 2 2378 9788.
E-mail address: henry11111@tmu.edu.tw (H.-C. Lin).
experience relapse. This could put them and their babies at
greater risk, outweighing risks associated with antipsychotics
use (Newport et al., 2007). Therefore, treating expectant
mothers with schizophrenia poses a challenge for patients,
their families, and doctors, since the most common onset of
schizophrenia is during childbearing ages (Miller, 1997).
Previous studies have attempted to document the impact of
antipsychotics on pregnancy outcome, but have yielded
inconsistent findings. A study by Newham et al. (2008)
reported that in utero exposure to atypical antipsychotics
may increase infant birth weight and incidences of babies large
for gestational age (LGA). A study by Reis and Kallen (2008)

0920-9964/$ – see front matter © 2009 Elsevier B.V. All rights reserved.
doi:10.1016/j.schres.2009.10.011
56 H.-C. Lin et al. / Schizophrenia Research 116 (2010) 55–60
found that the maternal use of antipsychotics was not asso-
ciated with preterm births, low birth weight (LBW), or SGA.
McKenna et al. (2005) concluded that women exposed to
atypical antipsychotics had significantly higher rates of low
birth weight (LBW) infants than those in the comparison group
(10% vs. 2%). However, the above studies not only look at
different sets of outcome, all analyses fail to take the disorder
itself into consideration. A plethora of studies have consistently
demonstrated the relationship between schizophrenia and
adverse pregnancy outcome. Therefore, studies of the effect of
antipsychotics on pregnancy outcome based on samples that
mixed patients with diverse types of mental disorders or other
chronic disorders may confound the findings.
Using a nationwide population-based dataset from Tai-
wan, the objective of this study was to compare the risk of
adverse pregnancy outcome including preterm birth, LBW,
LGA, and SGA among mothers with schizophrenia receiving
typical, atypical, and no antipsychotics during pregnancy and
comparison subjects after adjusting for the characteristics of
mother, father, and infant. We hypothesized that the risk of
adverse birth outcome increased among women with schizo-
phrenia, as compared to those without a psychiatric illness. The
maternal use of physician-approved antipsychotic medication
during pregnancy would possess minimal excess risk to the
pregnancy outcome. These findings may help clinicians
understand the possible impact of antipsychotics on pregnancy
outcome and indicate a better treatment choice for optimal
control of schizophrenic symptoms during pregnancy.
2. Methods
2.1. Database
For this study, we linked two nationwide population-based
datasets. The first dataset was sourced from the Taiwan
National Health Insurance Research Dataset (NHIRD), covering
the years 1996 to 2003. Taiwan inaugurated its National Health
Insurance (NHI) program in 1995 as a means of financing
healthcare for all Taiwanese citizens. The NHI has the following
characteristics: universal health insurance coverage, a single-
payer system with the government as the sole insurer and
payer, comprehensive benefits, and unrestricted choice of
physicians and medical institutions. The NHIRD currently
includes all medical claims data for over 22 million enrollees,
representing over 98% of the island's population. The NHIRD is
one of the largest and most comprehensive nationwide
population-based datasets currently available in the world,
and it presents a unique opportunity to explore the impact of
antipsychotics on pregnancy outcome among mothers with
schizophrenia.
The second database was the 2001–2003 birth certificate
registry published by the Ministry of the Interior in Taiwan.
The birth certificate registry provides data on birthdates for
both infants and their parents, gestational week at birth, birth
weight, gender, parity, place of birth, parental educational
levels, and maternal marital status. Since registration of all
births or deaths is mandatory in Taiwan, birth certificate data
are believed to be very accurate and comprehensive.
With assistance from the Bureau of the National Health
Insurance (NHI) in Taiwan, the mother's and infant's unique
personal identification numbers provided links between the
NHIRD and birth certificate data. Before release to the
researchers, all personal identifiers were encrypted by the
Bureau of NHI. Confidentiality assurances were addressed by
abiding to the data regulations of the Bureau of NHI. Since the
NHIRD consists of de-identified secondary data released to
the public for research purposes, this study was exempt from
full review by the Internal Review Board.
2.2. Study sample
A total of 473,529 women who had singleton live births
between January 1, 2001, and December 31, 2003 were
identified by the NHIRD. Since the ICD-9-CM coding system
was adopted by the NHIRD during this period, our study used
ICD-9-CM codes to retrieve patient profiles from the claims.
Of these women, 1184 had previously received treatment for
schizophrenia (any ICD-9-CM 295 code other than 295.7-
schizoaffective disorder), either as in a hospitalization or
ambulatory care setting within the three years preceding
their index deliveries. Since administrative databases have a
reputation for unreliable coding of diagnoses, we only
selected patients who had at least three consensus schizo-
phrenia diagnoses for the study cohort (n = 733). This helped
to ensure the validity of schizophrenia diagnosis. In addition,
we excluded the following: mothers who had taken both
typical and atypical antipsychotics during their pregnancies
(n = 7), mothers who have received injectable antipsychotics,
antiepileptics or lithium during pregnancy (n = 5), and
mothers who had taken either typical or atypical anti-
psychotics less than 30 days during pregnancy (n = 25).
Ultimately, 696 mothers with schizophrenia were included
as the study cohort for analysis.
The comparison cohort was comprised of those extracted
from the remaining 472,345 mothers in the database. We
excluded mothers who had once been diagnosed with any
type of mental disorder (ICD-9-CM codes 290–319) or
chronic diseases (such as systemic lupus erythematosis,
rheumatoid arthritis, gout, sarcoidosis, or ankylosing spon-
dylitis) between 1996 and 2003. Thereafter, we randomly
chose 3480 mothers (five for every mother with schizo-
phrenia) matched with the study group according to age (b20,
20–24, 25–29, 30–34, and ≥35 years), the year of delivery,
hypertension, and diabetes.
2.3. Variables of interest
At present, there is no ‘gold standard’ for schizophrenia
treatment during pregnancy. Therefore, in addition to
comparing pregnancy outcome between women with and
without schizophrenia, we divided the women with schizo-
phrenia into three categories: women not receiving anti-
psychotics during pregnancy, women receiving typical
antipsychotics during pregnancy, and women receiving
atypical antipsychotics during pregnancy. We defined
women receiving antipsychotics during pregnancy as those
who had been prescribed antipsychotics for more than
30 days while pregnant.
The outcome variables investigated were all dichotomous
and included the following: low birth weight (b2500 g),
preterm gestation (b37 weeks), small for gestational age
(SGA) (birth weight below the tenth percentile for
 H.-C. Lin et al. / Schizophrenia Research 116 (2010) 55–60 57

gestational age), and large for gestational age (LGA) (birth
weight above the tenth percentile for gestational age). We
chose these four parameters to evaluate poor obstetric outcome
because they could be clearly defined and were obviously
correlated with increased fetal morbidity, mortality, and
neurodevelopmental impairment (McCormick, 1985).
This study also took other possible confounding factors
related to pregnancy outcome into consideration, including
characteristics of the infant (gender and parity), mother
(age, the highest educational level and marital status), father
(age and the highest educational level), and family monthly
income (including mothers' and fathers' monthly income).
Parental ages were defined as each parent's age in years at
time of infant birth. Parity was grouped into the following
categories: 1, 2, and ≥ 3. Maternal and paternal education
levels were categorized into four levels: elementary school
or lower, junior high school, senior high school, college or
above. Family monthly income was categorized into four
groups: bNT$15,000, NT15,000–NT30,000, NT30,001–
NT50,000, ≥ NT50,001.
2.4. Statistical analysis
The SAS statistical package (SAS System for Windows,
Version 8.2) was used to perform analyses in this study. Pearson
χ2 tests were used to examine the differences between
pregnant women with schizophrenia and unaffected pregnant
women. After adjusting for the possible confounding factors,
separate multivariate logistic regression analyses were per-
formed to examine the risk of LBW, preterm gestation, SGA, and
LGA for mothers with and without schizophrenia. The odds
ratios (OR) and 95% confidence intervals (CI) for the estimated
ORs were calculated. A two-sided p value of b0.05 was
considered statistically significant.
atypical antipsychotics during pregnancy did not have higher
odds for LBW infants, preterm births, SGA, or LGA babies.
Women with schizophrenia who had received typical anti-
psychotics during pregnancy likewise did not have higher odds
of LBW infants, SGA, or LGA babies compared to those receiving
no antipsychotics. Similarly, we found that compared to
women with schizophrenia who had received typical anti-
psychotics, those who had received atypical antipsychotics
during pregnancy did not have higher odds of LBW infants,
preterm births, SGA, or LGA babies (not shown in the table).
However, women with schizophrenia who received typical
antipsychotics during pregnancy had higher odds of preterm
births (OR = 2.48, 95% CI= 1.51–4.08) compared to those not
receiving antipsychotics.
Table 3 also presents the adjusted OR for the risk of LBW,
preterm birth, SGA, and LGA for these four groups of mothers.
As the table shows, the adjusted odds of LBW and SGA for the
comparison cohort respectively were 0.72 (95% CI= 0.50–0.88)
and 0.81 (95% CI= 0.64–0.92) times those for women with
schizophrenia not receiving antipsychotics during pregnancy
after adjusting for infant gender, parity, maternal age, highest
maternal and paternal educational levels (separately), hyper-
tension, gestational diabetes, parental age difference, mother
marital status, and family monthly income. We found no
significant difference in the risk of LBW, preterm births, LGA,
and SGA babies between women with schizophrenia receiving
atypical antipsychotics during pregnancy and those not
receiving antipsychotics. However, the regression shows that
women with schizophrenia receiving typical antipsychotics
during pregnancy had higher adjusted odds of preterm births
(OR = 2.46, 95% CI = 1.50–4.11) compared to those not
receiving antipsychotics.
4. Discussion

3. Results In this nationwide, population-based retrospective study,

women with schizophrenia, regardless of whether they had
A total of 696 mothers with schizophrenia during the
study period were identified. In 242 pregnancies, mothers
received antipsychotics for treatment of schizophrenia. The Table 1
Antipsychotics used during pregnancies for 242 women with schizophrenia.
mean duration of antipsychotics use was 164 days (standard
deviation = 113 days). In 194 of these pregnancies, the Antipsychotics No. of patients (%)
women received typical antipsychotics. The distribution of Mono/polytherapy 242
antipsychotics used during pregnancy is listed in Table 1. Monotherapy 236 (97.5)
Table 2 shows the study and comparison cohort distributions Polytherapy 6 (2.5)
of the infant, mother, and father characteristics. Compared to
Monotherapy drugs (n = 236)
comparison subjects, mothers with schizophrenia were more
Typical antipsychotics (n = 190)
likely to be unmarried (pb 0.001), have educational level below Chlorpromazine 6 (3.2)
college (p b 0.001), and have family monthly income less than Clopenthixol 2 (1.1)
NT$50,000 (p b 0.001). Fathers in the study cohort were more Clothiapine 6 (3.2)
likely to be older than 34 years (p= 0.004) and have educational Flupentixol 55 (28.9)
Haloperidol 33 (17.4)
levels below college (p b 0.001). No significant difference in Loxapine 1 (0.5)
infant gender was observed between these two cohorts. Pimozide 1 (0.5)
Table 3 describes the distribution and crude odds ratios for Sulpiride 77 (40.5)
LBW, preterm birth, SGA, and LGA comparing mothers with Thioridazine 4 (2.1)
Trifluoperazine 5 (2.6)
schizophrenia receiving various treatments during pregnancy
Atypical antipsychotics (n = 46)
and control subjects. It consistently shows that of the four Clozapine 5 (10.9)
groups, the comparison cohort had the lowest percentages of Olanzapine 13 (28.3)
LBW, preterm birth, and SGA. Multivariate logistic regression Quetiapine 7 (15.2)
analyses show that compared to women with schizophrenia Risperidone 16 (34.8)
Zotepine 5 (10.9)
who had received no antipsychotics, those who received
58 H.-C. Lin et al. / Schizophrenia Research 116 (2010) 55–60

Table 2 of preterm birth (OR = 2.46), after adjusting for potential

Comparisons of mothers with schizophrenia and comparison subjects, in confounders. Typical antipsychotics, if indicated, should be
relation to maternal, paternal, and infant characteristics in Taiwan, 2001–2003
(n = 4176).
used with caution particularly with respect to preterm birth
during pregnancy, although this result is preliminary and
Variable Comparison Women with p value could be influenced by confounding factors unavailable to the
subjects schizophrenia
database, such as maternal smoking or alcohol and substance
n = 3480 n = 696 use. In addition, simultaneous administration of anticho-
Total no. % Total no. % linergic drugs, are known to be potentially teratogenic, and
thus not recommended during pregnancy (Kohen, 2004); yet
Infant characteristics
Gender 0.389
these are common and sometimes unavoidable among
Male 1887 54.2 365 52.4 patients receiving typical antipsychotics. Regarding preterm
Female 1593 45.8 331 47.6 births, little information was available to indicate its
Parity 0.025 relationship with anticholinergic drug use during pregnancy.
1 1653 47.5 344 49.4
Furthermore, the use of antipsychotics in pregnancy should
2 1275 36.6 221 31.8
3 or more 552 15.9 131 18.8 always be noted for the possibility of neonatal complications,
including extrapyramidal syndrome, jaundice, and intestinal
Maternal characteristics obstruction (Hauser, 1985; Falterman and Richardson, 1980;
Age (year) 1.000 Kohen, 2004). Differences in maternal characteristics, including
b20 120 3.5 24 3.5
20–24 525 15.1 105 15.1
severity of disease, may distinguish women with schizophrenia
25–29 1160 33.3 232 33.3 receiving typical antipsychotics from others. Despite the risks,
30–34 1145 32.9 229 32.9 the reasons for the use of typical antipsychotics by pregnant
N34 530 15.2 106 15.2 schizophrenic women remain unclear.
Education level b 0.001
Information regarding atypical antipsychotic use during
Elementary school or lower 73 2.1 23 3.3
Junior high school 540 15.5 72 24.7 pregnancy is also inadequate. Although atypical antipsychotics
Senior high school 2295 66.0 431 61.9 have been used extensively in schizophrenia treatment (they
College or above 572 16.4 70 10.1 are more effective for negative symptoms and produce less
Marital status b 0.001 extrapyramidal syndrome (Gentile, 2004)), the use of typical
Married 3387 97.3 642 92.2
Others 93 2.7 54 7.8
antipsychotics is still encouraged in view of their relatively
Family monthly income b 0.001 better established safety profile (Menon, 2008). In this study,
bNT$15,000 1090 31.3 209 30.0 compared to women with schizophrenia receiving either no
NT$15,000– 30,000 896 25.8 236 33.9 antipsychotics or typical agents during pregnancy, women
NT$30,001–50,000 948 27.2 214 30.8
receiving atypical agents were at no higher risk of adverse
NNT$50,000 546 15.7 37 5.3
pregnancy outcome other than preterm births. However, more
Paternal characteristics evidence is required before the routine use of atypical
Age (year) 0.004 antipsychotics during pregnancy can be recommended
b30 1140 32.8 195 28.0 (ACOG Practice Bulletin, 2008).
30–34 1316 37.8 255 36.6
N34 1024 29.4 246 35.3
Another concern about atypical antipsychotics during
Education level b 0.001 pregnancy comes from their tendency to affect weight.
Elementary school or lower 52 1.5 37 5.3 Atypical antipsychotics are considered more likely to induce
Junior high school 648 18.6 183 26.3 maternal hyperglycaemia, impair glucose tolerance, and
Senior high school 2075 59.6 399 57.3
induce weight gain, all of which may lead to unfavorable
College or above 705 20.3 77 11.1
pregnancy outcome (Menon, 2008). In fact, a recent prospec-
tive study by Newham et al. found that the use of atypical
antipsychotics during pregnancy might increase the risk of
received antipsychotics during pregnancy, had an increased LGA (2008). However, the sample size was relatively small
risk of delivering babies with LBW and SGA than the and the patients recruited had heterogeneous diagnoses.
comparison cohort. As shown by an earlier meta-analytic A prospective study by McKenna et al. concluded that
study, women with schizophrenia were at higher risk for exposure to atypical antipsychotics during pregnancy did not
obstetric complications, including LBW and poor neonatal display an increased risk for adverse pregnancy outcome
conditions, than the general population (Sacker et al., 1996). (2005). No differences in the mean birth weight between
Several recent studies have provided more clear-cut evidence. infants born to mothers receiving atypical antipsychotics and
The absence of etiological evidence, genetic liability, and comparison subjects were observed. In partial accordance
maternal risk factors including exposure to antipsychotics with their findings, we did not find an increased risk of LGA
during pregnancy are considered to account for adverse among pregnant mothers with schizophrenia receiving
pregnancy outcome (Jablensky et al., 2005). However, since atypical antipsychotics.
the risks for LBW and SGA among women with schizophrenia The strength of this study is that it uses two nationwide,
did not differ regardless of antipsychotics use, exposure to population-based datasets. The large sample size not only
antipsychotics during pregnancy does not appear to be a major represents the general pregnant population in Taiwan but also
factor accounting for increased reproductive pathology. provides ample statistical power to detect differences between
Women with schizophrenia receiving typical antipsy- comparison subjects and women with schizophrenia receiving
chotics during pregnancy were noted to be at increased risk various interventions during pregnancy. However, three main
 H.-C. Lin et al. / Schizophrenia Research 116 (2010) 55–60 59

Table 3
Crude and adjusted odds ratios for LBW, preterm birth, SGA, and LGA for women with schizophrenia receiving various treatments and comparison subjects, 2001–2003
(n = 4176).

Variable Comparison subjects Women with schizophrenia

n = 3480
No antipsychotics Typical antipsychotics Atypical antipsychotics
during pregnancy during pregnancy during pregnancy
n = 454 n = 194 n = 48

Total no. % Total no. % Total no. % Total no. %

Low birth weight

Yes 207 5.9 41 9.0 16 8.2 6 12.5
No 3273 94.1 413 91.0 178 91.8 42 87.5
Crude OR (95% CI) 0.64 ⁎ (0.45–0.90) 1.00 0.91 (0.50–1.66) 1.44 (0.58–3.59)
Adjusted OR (95% CI) a 0.72 ⁎ (0.50–0.88) 1.00 0.95 (0.50–1.75) 1.71 (0.67–4.34)
Preterm birth
Yes 255 7.3 37 8.2 35 18.0 6 12.5
No 3225 92.7 417 91.8 159 82.0 42 87.5
Crude OR (95% CI) 0.89 (0.62–1.28) 1.00 2.48 ⁎⁎ (1.51–4.08) 1.61 (0.64–4.04)
Adjusted OR (95% CI) a 0.97 (0.67–1.41) 1.00 2.46 ⁎⁎ (1.50–4.11) 1.61 (0.63–4.12)
Small for gestational age
Yes 553 15.9 92 20.3 49 25.3 10 20.8
No 2927 84.1 362 79.7 145 74.7 38 79.2
Crude OR (95% CI) ⁎
0.74 (0.58–0.95) 1.00 1.33 (0.89–1.98) 1.04 (0.50–2.16)
Adjusted OR (95% CI) a ⁎
0.81 (0.64–0.92) 1.00 1.39 (0.93–2.08) 1.15 (0.55–2.41)
Large for gestational age
Yes 303 8.7 44 9.7 15 7.7 3 6.3
No 3177 91.3 410 90.3 179 92.3 45 93.7
Crude OR (95% CI) 0.89 (0.64–1.24) 1.00 0.78 (0.42–1.44) 0.62 (0.19–2.08)
Adjusted OR (95% CI) a 0.89 (0.63–1.25) 1.00 0.72 (0.39–1.34) 0.55 (0.16–1.85)

Note: OR = odds ratio; CI = confidence interval.

⁎ p b 0.05.
⁎⁎ p b 0.001.
a
Adjusted for maternal age, educational level, marital status, hypertension, and diabetes, together with infant's gender and parity, family monthly income,
paternal educational level, and parental age difference.

limitations are noteworthy. First, there was a lack of dataset
information regarding maternal characteristics related to
pregnancy outcome, such as maternal smoking, alcohol, and
other substance use, pre-pregnancy BMI, and nutritional status.
Secondly, due to statistical complexity, antipsychotropic
dosages and the simultaneous administration of other psycho-
tropic and non-psychotropic agents were not taken into
consideration. In addition, information on over-the-counter
drug utilization was unavailable. When using claims data, a
patient's adherence to medication is always problematic.
Finally, as the operational criteria in diagnosing psychiatric
diseases has been modified from ICD-9 during a period of ICD-
10 data assessment in the current coding system, the inclusion
of mothers with schizophrenia might vary over time. Jansson
et al. (2002) reported that ICD-10 appears to be a more
conservative system, with ICD-9 its more liberal counterpart. All
patients diagnosed with schizophrenia in ICD-10 covered the
ICD-9 definition. The inter-rater reliability of ICD-9 diagnosis
was lower than that for ICD-10 (kappa 0.505 vs. 0.855). It is
possible mothers had been recruited with some diagnostic
category other than those defined and labeled under the current
diagnosis system.
The management of expectant mothers with schizophrenia
poses a dilemma. Discontinuing antipsychotics use during
pregnancy may put them at a higher risk of relapse. Indeed,
risks associated with untreated schizophrenia might outweigh
those associated with treatment (Newport et al., 2007).
Nevertheless, knowledge regarding the risks of adverse
pregnancy outcome for women with schizophrenia receiving
antipsychotics during pregnancy is far from complete. The
conceptual model proposed by Wisner et al. for structuring
risk–benefit decision making based on evidence may hopefully
achieve optimal maternal and infant outcome (2007). We hope
the results of this study are a meaningful addition to the limited
published evidence regarding the safety profile of atypical
antipsychotics during pregnancy.
Risk–benefit evaluations of different antipsychotics for
women with schizophrenia during pregnancy are necessary
for the optimal control of psychiatric symptoms throughout
the pregnancy. Therefore, prospective studies that take into
account more maternal characteristics and prescription data
should be completed to obtain more reliable conclusions.
Role of funding source
None.
Contributors
Authors Herng-Ching Lin and I-Ju Chen designed the study and wrote the
draft. Authors Dr. Yi-Hua Chen, Hsin-Chien Lee, I-Ju Chen and Fang-Jen Wu
managed the literature searches and analyses. Authors Herng-Ching Lin, Yi-Hua
Chen and Hsin-Chien Lee undertook the statistical analysis. All authors
contributed to and have approved the final manuscript.
Conflict of interest
None.
Acknowledgements
This study is based in part on the data from the National Health Insurance
Research Database provided by the Bureau of National Health Insurance,
Department of Health and managed by the National Health Research
Institutes, Taiwan. The interpretations and conclusions contained herein do
not represent those of the Bureau of National Health Insurance, Department
of Health, or the National Health Research Institutes.
60 H.-C. Lin et al. / Schizophrenia Research 116 (2010) 55–60
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