Antipsychotics may increase gestational diabetes risk during pregnancy

May 7 (UPI) — Some antipsychotic drugs prescribed during pregnancy have been associated with added risk of gestational diabetes, according to a nationwide analysis of data.

About 50 percent of women with gestational diabetes develop type 2 diabetes in the years after pregnancy, which prompted researchers to study the effects of various medical treatments during pregnancy. The findings were published Monday in American Journal of Psychiatry and presented at the American Psychiatric Association’s annual meeting through Wednesday in New York.

Gestational diabetes, like other forms of diabetes, affects how cells use glucose, leading to high blood sugar. Up to 10 percent of pregnancies in the United States are affected by gestational diabetes, according to the Centers for Disease Control and Prevention.

In the general population, certain antipsychotic drugs used to treat bipolar disorder, schizophrenia and other severe mental health disorders have been associated with weight gain and diabetes. These drugs include aripiprazole, ziprasidone, quetiapine, risperidone and olanzapine.

“The risks of gestational diabetes observed during pregnancy are in line with expectations based on the metabolic side effects observed in the general population,” Dr. Krista F. Huybrechts, an epidemiologist at Brigham and Women’s Hospital, said in a press release. “Certain antipsychotics have different levels of risk of metabolic side effects.”

The researchers analyzed the records of nondiabetic pregnant women who were enrolled in Medicaid between 2000 and 2010, and received one or more prescriptions dispensed for an antipsychotic drug during the three months before pregnancy. Among 1.5 million pregnancies, 1,924 were taking aripiprazole, 673 ziprasidone, 4,533 quetiapine, 1,824 risperidone and 1,425 olanzapine.

Two of the drugs showed a statistically significant increased risk for gestational diabetes compared with women who discontinued these medications: 61 percent for olanzapine and 28 percent for quetiapine.

Gestational diabetes was also associated with preeclampsia, cesarean delivery, neonatal hypoglycemia and macrosomia.

“Clinicians must weigh the benefits of staying on a stable regimen against the risks of continuing treatment with a higher-risk atypical antipsychotic during pregnancy to make an informed decision about the best course of treatment for the patient in question,” Huybrechts said.

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