IMPACT OF ATYPICAL ANTIPSYCHOTIC MEDICATION CONTINUATION ON MATERNAL METABOLIC HEALTH DURING PREGNANCY, A SYSTEMATIC REVIEW
Main Article Content
Keywords
Pregnancy, atypical antipsychotics, maternal metabolic health, gestational diabetes, systematic review
Abstract
This systematic review aims to assess the impact of atypical antipsychotic medication on the metabolic health of pregnant women. A comprehensive search of several databases identified pertinent studies from the past decade, focusing on the effects of these medications during pregnancy. The review included an evaluation of the methodological quality of the selected research. The key findings indicate an increased risk of gestational diabetes with specific drugs, such as olanzapine and quetiapine, highlighting the need for careful monitoring. Additionally, notable correlations were observed between the use of atypical antipsychotics and birth abnormalities, particularly in women with pre-pregnancy obesity and substance use. The study underscores the lack of guidelines for managing schizophrenia and bipolar disorder during pregnancy and the conflicting evidence regarding medication safety. It also examines maternal metabolic adaptations, focusing on changes in lipid and glucose metabolism. The review emphasizes the importance of further research to fully understand the safety and efficacy of these medications, aiming to improve health outcomes for both mothers and fetuses during pregnancy.
References
2. Cuenca, D. (2023). Pregnancy loss: Consequences for mental health. Frontiers in global women's health, 3, 1032212.
3. Fernandes, D. V., Canavarro, M. C., & Moreira, H. (2021). The mediating role of parenting stress in the relationship between anxious and depressive symptomatology, mothers’ perception of infant temperament, and mindful parenting during the postpartum period. Mindfulness, 12, 275-290.
4. Glover, V. (2015). Prenatal stress and its effects on the fetus and the child: possible underlying biological mechanisms. Perinatal programming of neurodevelopment, 269-283.
5. Grigoriadis, S., Graves, L., Peer, M., Mamisashvili, L., Tomlinson, G., Vigod, S. N., Dennis, C.-L., Steiner, M., Brown, C., & Cheung, A. (2018). Maternal anxiety during pregnancy and the association with adverse perinatal outcomes: systematic review and meta-analysis. The Journal of clinical psychiatry, 79(5), 813.
6. Herba, C. M., Glover, V., Ramchandani, P. G., & Rondon, M. B. (2016). Maternal depression and mental health in early childhood: an examination of underlying mechanisms in low-income and middle-income countries. The Lancet Psychiatry, 3(10), 983-992.
7. Howard, L. M., & Khalifeh, H. (2020). Perinatal mental health: a review of progress and challenges. World Psychiatry, 19(3), 313-327.
8. Lahti, M., Savolainen, K., Tuovinen, S., Pesonen, A.-K., Lahti, J., Heinonen, K., Hämäläinen, E., Laivuori, H., Villa, P. M., & Reynolds, R. M. (2017). Maternal depressive symptoms during and after pregnancy and psychiatric problems in children. Journal of the American Academy of Child & Adolescent Psychiatry, 56(1), 30-39. e37.
9. Lewis, A. J., Austin, E., Knapp, R., Vaiano, T., & Galbally, M. (2015). Perinatal maternal mental health, fetal programming and child development. Healthcare,
10. Mudiyanselage, S. B., Wanni Arachchige Dona, S., Angeles, M. R., Majmudar, I., Marembo, M., Tan, E. J., Price, A., Watts, J. J., Gold, L., & Abimanyi-Ochom, J. (2024). The impact of maternal health on child’s health outcomes during the first five years of child’s life in countries with health systems similar to Australia: A systematic review. PLoS One, 19(3), e0295295.
11. Park, Y., Hernandez-Diaz, S., Bateman, B. T., Cohen, J. M., Desai, R. J., Patorno, E., Glynn, R. J., Cohen, L. S., Mogun, H., & Huybrechts, K. F. (2018). Continuation of atypical antipsychotic medication during early pregnancy and the risk of gestational diabetes. American Journal of Psychiatry, 175(6), 564-574.
12. Phelan, S. T. (2023). Screening for social determinants of health during prenatal care: why, what, and how. Obstetrics and Gynecology Clinics, 50(3), 629-638.
13. Scarlett, H., Moirangthem, S., & van der Waerden, J. (2023). The impact of paternal mental illness on child development: an umbrella review of systematic reviews and meta-analyses. European Child & Adolescent Psychiatry, 1-14.
14. Shahhosseini, Z., Pourasghar, M., Khalilian, A., & Salehi, F. (2015). A review of the effects of anxiety during pregnancy on children’s health. Materia socio-medica, 27(3), 200.
15. Stentzel, U., Grabe, H. J., Schmidt, S., Tomczyk, S., van den Berg, N., & Beyer, A. (2023). Mental health-related telemedicine interventions for pregnant women and new mothers: a systematic literature review. BMC psychiatry, 23(1), 292.
16. Van den Bergh, B. R., van den Heuvel, M. I., Lahti, M., Braeken, M., de Rooij, S. R., Entringer, S., Hoyer, D., Roseboom, T., Räikkönen, K., & King, S. (2020). Prenatal developmental origins of behavior and mental health: The influence of maternal stress in pregnancy. Neuroscience & Biobehavioral Reviews, 117, 26-64.
17. Vickery, P. B. (2023). Concepts for selection and utilization of psychiatric medications in pregnancy. Mental Health Clinician, 13(6), 255-267.
18. Waheed, M. I. A., Jaiswal, A., Yelne, S., & Nandanwar, V. (2024). Navigating Perinatal Challenges: A Comprehensive Review of Cholestasis of Pregnancy and Its Impact on Maternal and Fetal Health. Cureus, 16(4).
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Fazilat Jamala
North West General Hospital & Research Center Hayatabad Peshawar, Khyber Medical University Peshawar, Pakistan.
Dr. Sarwat Ali Raja
Yashfeen College of Pharmacy & Allied Health Sciences, Pakistan.
Dr. Erum Khan
Lecturer, Community Medicine, Karachi Medical and Dental College, Karachi, Pakistan.
Zunaira Shakeel
Medical Officer, Connection Clinic for Comprehensive Psychiatric Services, Pakistan.
Fatima Jahan
Lecturer, Department of Zoology, Shaheed Benazir Bhutto Women University Peshawar, Pakistan.
Maria Jose Heredia S
General Practitioner, Department of Internal Medicine, Pontificia Universidad Católica del Ecuador.
Rabia Taj
Department of Zoology, Shaheed Benazir Bhutto Women University Peshawar, Pakistan.