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Maternal use of antipsychotics in early pregnancy: little evidence of increased risk of congenital malformations

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QUESTION

Question:

Does the use of antipsychotics in early pregnancy increase the risk of congenital malformations?

People:

All births recorded on the Swedish Medical Birth Register between July 1995 and the end of 2005. This included 973 767 infants from 958 729 women, of whom 2908 reported using ⩾1 antipsychotic medication early in pregnancy.

Setting:

Sweden; all recorded births between July 1995 and end of 2005.

Risk factors:

Information about all drug use was routinely collected in the first antenatal interview with a midwife and recorded in the Medical Birth Register. Antipsychotic use was subsequently split into use of dixyrazine or prochlorperazine (irrespective of use of any other antipsychotic) and use of “other antipsychotics”. Dixyrazine and prochlorperazine are commonly used in the treatment of nausea and vomiting in pregnancy. Women using lithium were not included in the main analyses.

Outcomes:

Congenital malformations, as recorded on the Medical Birth Register, the Swedish Register of Congenital Malformations and the Hospital Discharge Register. All ORs were adjusted …

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