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Neurodevelopmental outcomes in infants exposed in utero to antipsychotics: a systematic review of published data

Published online by Cambridge University Press:  21 November 2016

Salvatore Gentile  and
Maria Luigia Fusco
Salvatore Gentile*
Affiliation:
Department of Mental Health ASL Salerno, Cava de’ Tirreni, Salerno, Italy Medical School “Federico II”, Department of Neurosciences, Perinatal Psychiatry, University of Naples, Naples, Italy
Maria Luigia Fusco
Affiliation:
Developmental Psychologist, Mental Health Institute, Torre Annunziata, Naples, Italy Post-graduate School of Psychology (SIPGI), Campania, Italy
*
*Address for correspondence: Salvatore Gentile, MD, PhD, Department of Mental Health ASL Salerno, Mental Health Center n. 63, Cava de’ Tirreni, Vietri sui Mare, Piazza Galdi, 841013 Cava de’ Tirreni, Salerno, Italy. (Email: [email protected])
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Abstract

The proportion of pregnancies exposed to either second-generation antipsychotics (SGAs) or first-generation antipsychotics (FGAs) varies between 0.3%–2% of all pregnancies, but, until now, little is known about the potential neurobehavioral teratogenicity of antipsychotics. Assessing this safety facet is the aim of this article. PubMed, Scopus, and Google Scholar were searched for eligible articles. PubMed (1954 to May 2016) was searched using several medical subject headings, variously combined. PubMed search results were also limited using the search filter for human studies published in English. Scopus and Google Scholar searches were filtered for article title (antipsychotics/neuroleptics, pregnancy). After excluding duplicates, 9,250 articles were identified and 29 met the following inclusion criteria: only articles that provided original/primary data on neurodevelopmental outcome in human offspring older than 4 months of age, independently of the study design, were selected for review. Indeed, some relevant neurodevelopmental milestones are achieved at this time. Length of study and neurodevelopmental assessment methodology did not influence the study selection. Unfortunately, published data on neurodevelopmental teratogenicity of SGAs mainly derive from case reports and small case-series studies. Even findings emerging from case-control and prospective/retrospective studies are of limited clinical relevance because of their small sample sizes. Limited data are also available on FGAs. Hence, we have to conclude that the long-term neurodevelopmental outcomes for children exposed in utero remain unclear. Low to very low quality evidence of retrieved data makes impossible to confirm or exclude potential long-lasting untoward effects on infant neurocognitive development associate with antenatal exposure to either SGAs or FGAs.

Keywords

Antipsychoticsneurodevelopmental teratogenicityneurolepticspregnancysafety
Type
Review Articles
Information
CNS Spectrums , Volume 22 , Issue 3 , June 2017 , pp. 273 - 281
Copyright
© Cambridge University Press 2016 

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Footnotes

Dr. Gentile and Dr. Fusco wish to acknowledge Kay McCauley-Elsom and Christina Wichman for having kindly provided additional relevant information about their articles.

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