Aripiprazole Unlikely to Pose Metabolic Risk During Pregnancy

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The use of aripiprazole during pregnancy was associated with an increased risk for hypertension and lower birth rate.
The use of aripiprazole during pregnancy was associated with an increased risk for hypertension and lower birth rate.

Women who took aripiprazole during pregnancy did not show elevated metabolic risks when compared with the general population rate and, although they did show higher rates of pregnancy hypertension and more frequent instances of admission to a special care nursery or neonatal intensive care unit (SCN/NICU), these rates were higher for women who stopped taking aripiprazole before the third trimester than for those who continued taking the medication throughout pregnancy, according to a study published in the Journal of Affective Disorders.

Study investigators used data from hospitals with extensive records of diagnosis, exposures, complications, and outcomes during pregnancy. These data were gathered from the medical records of 2 tertiary maternity hospitals in Western Australia, which both have antenatal clinics for pregnant women with severe mental illnesses. Across these 2 hospitals, 26 women who took aripiprazole while pregnant were identified, 14 of whom ceased taking the medication before the third trimester and 12 who continued to take aripiprazole for the duration of the pregnancy.

The rates of gestational diabetes among the study participants was marginally lower than the general population rate in Australia (7.7% vs 9.4%), and the rate of antepartum hemorrhage was marginally higher (7.7% vs 3.6%), although neither difference was significant. The rate of pregnancy hypertension found among women who took aripiprazole was 15.4% compared with 3.7% in the Australian population, and the rates of admission to SCN/NICU were 38.5% compared with the usual 16%, although the trend for both complications were actually lower for patients who continued taking aripiprazole throughout the pregnancy than for those who ceased taking it before the third trimester.

Study investigators conclude, although “this study cannot answer the question of whether aripiprazole is safe for use in pregnancy when treating women with serious mental illness, the data supports this agent as being unlikely to have a metabolic risk in pregnancy. However, the lower gestational age and birth weight, higher SCN/NICU admission rate and elevated gestational hypertension rates identified should be further explored in powered and well-designed studies.”

Reference

Galbally M, Frayne J, Watson SJ, Snellen M. Aripiprazole and pregnancy: A retrospective, multicentre study. J Affect Disord. 2018; 238:593-596.

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