Maternal schizophrenia and pregnancy outcome: does the use of antipsychotics make a difference?

OBJECTIVE: This study compared the risk of adverse pregnancy outcome-including preterm births, low birth weight (LBW), large-gestational-age (LGA), and small-gestational-age (SGA)-among mothers with schizophrenia receiving typical, atypical, and no antipsychotics during pregnancy. They were all compared with control subjects.

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 schizophrenia and 3480 matched unaffected mothers were included for analysis. After adjusting for characteristics of mother, father, and infants, multivariate logistic regression analyses were 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.