Association between prenatal antipsychotic exposure and the risk of attention-deficit/hyperactivity disorder and autism spectrum disorder: a systematic review and meta-analysis

Neurosci Biobehav Rev. 2024 May:160:105635. doi: 10.1016/j.neubiorev.2024.105635. Epub 2024 Mar 16.

Abstract

The paucity of evidence regarding the safety of gestational antipsychotic exposure has led to treatment discontinuation in pregnant women with severe mental health conditions. This systematic review and meta-analysis aimed to summarise the current evidence on the association between gestational antipsychotic exposure and attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in children (Study protocol registered in PROSPERO:CRD42022311354). Five studies included in our meta-analysis with around 8.6 million pregnancy episodes in nine different countries/regions. Results from our meta-analysis indicate that the heightened risks of ASD and ADHD in children gestationally exposed to antipsychotics appear to be attributable to maternal characteristics, rather than having a causal relationship with the antipsychotic exposure during pregnancy. The results underscore the importance of meticulously monitoring the neurodevelopment of children born to mothers with mental illnesses, which can facilitate early interventions and provide requisite support.

Keywords: Antipsychotic; Attention-deficit/hyperactivity disorder; Autism spectrum disorder; Pregnancy.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Antipsychotic Agents* / adverse effects
  • Attention Deficit Disorder with Hyperactivity* / chemically induced
  • Attention Deficit Disorder with Hyperactivity* / drug therapy
  • Autism Spectrum Disorder* / chemically induced
  • Autism Spectrum Disorder* / epidemiology
  • Female
  • Humans
  • Pregnancy
  • Pregnancy Complications / chemically induced
  • Pregnancy Complications / drug therapy
  • Prenatal Exposure Delayed Effects* / chemically induced

Substances

  • Antipsychotic Agents