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Sökning: onr:"swepub:oai:prod.swepub.kib.ki.se:148183936" > Antipsychotic use i...

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FältnamnIndikatorerMetadata
00003701naa a2200457 4500
001oai:prod.swepub.kib.ki.se:148183936
003SwePub
008240913s2022 | |||||||||||000 ||eng|
0247 a http://kipublications.ki.se/Default.aspx?queryparsed=id:1481839362 URI
0247 a https://doi.org/10.1136/ebmental-2021-3003112 DOI
040 a (SwePub)ki
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Halfdanarson, O4 aut
2451 0a Antipsychotic use in pregnancy and risk of attention/deficit-hyperactivity disorder and autism spectrum disorder: a Nordic cohort study
264 c 2021-11-22
264 1b BMJ,c 2022
520 a Antipsychotics are increasingly used among women of childbearing age and during pregnancy.ObjectiveTo determine whether children exposed to antipsychotics in utero are at increased risk of attention-deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD), accounting for maternal diagnoses of bipolar, psychotic and other psychiatric disorders.DesignPopulation-based cohort study, including a sibling analysis.SettingNationwide data on all pregnant women and their live-born singletons in Denmark (1997-2017), Finland (1996-2016), Iceland (2004-2017), Norway (2004-2017), and Sweden (2006-2016).Participants4 324 086 children were eligible for inclusion to the study cohort.InterventionAntipsychotic exposure in utero, assessed by pregnancy trimester, type of antipsychotic, and varying patterns of use.Main outcome measuresNon-mutually exclusive diagnoses of ADHD and ASD. We used Cox proportional hazard models to calculate hazard ratios (HRs) controlling for maternal psychiatric disorders and other potential confounding factors.FindingsAmong 4 324 086 singleton births, 15 466 (0.4%) were exposed to antipsychotics in utero. During a median follow-up of 10 years, we identified 72 257 children with ADHD and 38 674 children with ASD. Unadjusted HRs were raised for both outcomes but shifted substantially towards the null after adjustment; 1.10 (95%CI 1.00 to 1.27) for ADHD and 1.12 (0.97 to 1.29) for ASD. Adjusted HRs remained consistent by trimester of exposure and type of antipsychotic. Comparing in utero exposure with pre-pregnancy use yielded HRs of 0.74 (0.62 to 0.87) for ADHD and 0.88 (0.70 to 1.10) for ASD. Sibling analyses yielded HRs of 1.14 (0.79 to 1.64) for ADHD and 1.34 (0.75 to 2.39) for ASD.DiscussionOur findings suggest little or no increased risk of child ADHD or ASD after in utero exposure to antipsychotics.Clinical implicationsResults regarding child neurodevelopment are reassuring for women who need antipsychotics during pregnancy.
7001 a Cohen, JM4 aut
7001 a Karlstad, O4 aut
7001 a Cesta, CEu Karolinska Institutet4 aut
7001 a Bjork, MH4 aut
7001 a Haberg, SE4 aut
7001 a Einarsdottir, K4 aut
7001 a Furu, K4 aut
7001 a Gissler, Mu Karolinska Institutet4 aut
7001 a Hjellvik, V4 aut
7001 a Kieler, Hu Karolinska Institutet4 aut
7001 a Leinonen, MK4 aut
7001 a Norgaard, M4 aut
7001 a Essen, BO4 aut
7001 a Ulrichsen, SP4 aut
7001 a Reutfors, Ju Karolinska Institutet4 aut
7001 a Zoega, H4 aut
7102 a Karolinska Institutet4 org
7730 t Evidence-based mental healthd : BMJg 25:2, s. 54-62q 25:2<54-62x 1468-960Xx 1362-0347
8564 u https://ebmh.bmj.com/content/ebmental/early/2021/11/28/ebmental-2021-300311.full.pdf
8564 8u http://kipublications.ki.se/Default.aspx?queryparsed=id:148183936
8564 8u https://doi.org/10.1136/ebmental-2021-300311

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