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Atypical Antipsychotics May Cross Placenta in Pregnancy

Medication can be detected in umbilical cord blood, with possible adverse outcomes

MONDAY, Aug. 27 (HealthDay News) -- Atypical antipsychotic drugs can be detected in umbilical cord blood and may be associated with adverse pregnancy outcomes, researchers report in the August issue of the American Journal of Psychiatry.

D. Jeffrey Newport, M.D., of the Emory University School of Medicine in Atlanta, and colleagues collected maternal blood and umbilical cord blood samples in 50 maternal-infant pairs.

The researchers found that placental passage (defined as the ratio of umbilical cord to maternal plasma concentrations, ng/mL) was higher for olanzapine (mean, 72.1 percent) than for haloperidol (mean, 65.5 percent), risperidone (mean, 49.2 percent) and quetiapine (mean, 23.8 percent). Such concentrations would likely mean considerable exposure to the fetal lung and brain, the report indicates. The investigators also found neonates exposed to olanzapine had higher rates of low birth weight (30.8 percent) and neonatal intensive care unit admission (30.8 percent).

"Not only is the use of atypical antipsychotics for an array of disorders increasingly common among women of childbearing age, but women treated with these prolactin-sparing agents, with the exception of risperidone, may be more susceptible to unplanned pregnancy than those receiving conventional antipsychotics," the authors conclude. "Consequently, data regarding the reproductive safety of these compounds bear tremendous public health implications."

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