Marlene P Freeman1, Alexandra Z Sosinsky2, Lina Goez-Mogollon2, Gina M Savella2, Danna Moustafa2, Adele C Viguera3, Lee S Cohen2. 1. Massachusetts General Hospital, Department of Psychiatry, Ammon-Pinizzotto, Center for Women's Mental Health, Boston, MA. Electronic address: mfreeman@mgh.harvard.edu. 2. Massachusetts General Hospital, Department of Psychiatry, Ammon-Pinizzotto, Center for Women's Mental Health, Boston, MA. 3. Massachusetts General Hospital, Department of Psychiatry, Ammon-Pinizzotto, Center for Women's Mental Health, Boston, MA; Cleveland Clinic, Department of Psychiatry, Neurological Institute, Cleveland, OH.
Abstract
BACKGROUND: Obesity during pregnancy is the most common high-risk obstetric condition, resulting in increased rates of adverse maternal and neonatal outcomes. Individuals with psychiatric disorders have a higher risk of obesity than the general population, but data regarding implications of obesity in women with psychiatric disorders are sparse. OBJECTIVE: The objective of this study was to assess pre-pregnancy weights and gestational weight gain in women who were exposed to second-generation antipsychotics (SGAs) during pregnancy compared to controls. METHODS: We assessed pre-pregnancy weights and gestational weight gain from the Massachusetts General Hospital National Pregnancy Registry for Atypical Antipsychotics for patients exposed to SGAs and controls unexposed to these medicines during pregnancy. Both groups experienced similar psychiatric morbidity. RESULTS: A total of 403 participants had evaluable data for these analyses (N = 279 exposed to SGAs; N = 124 controls). The mean pre-pregnancy weight, body mass index (BMI), and likelihood to begin pregnancy with an obese BMI were significantly higher in the exposed group compared to controls (p = 0.0003, p < 0.0001, and p < 0.0001 respectively), as were the mean weight and BMI at delivery (p < 0.0001). The mean weight gain did not differ significantly between groups. Across pre-pregnancy BMI categories, both groups gained more than the recommended amount of weight during pregnancy. CONCLUSION: We found that women exposed to SGAs began pregnancy with higher BMIs than controls. Both exposed and unexposed groups experienced similar weight gain during pregnancy. Strategies are needed to prevent excessive gestational weight gain and to reduce pre-pregnancy obesity in women with psychiatric disorders, especially those treated with SGAs.
BACKGROUND:Obesity during pregnancy is the most common high-risk obstetric condition, resulting in increased rates of adverse maternal and neonatal outcomes. Individuals with psychiatric disorders have a higher risk of obesity than the general population, but data regarding implications of obesity in women with psychiatric disorders are sparse. OBJECTIVE: The objective of this study was to assess pre-pregnancy weights and gestational weight gain in women who were exposed to second-generation antipsychotics (SGAs) during pregnancy compared to controls. METHODS: We assessed pre-pregnancy weights and gestational weight gain from the Massachusetts General Hospital National Pregnancy Registry for Atypical Antipsychotics for patients exposed to SGAs and controls unexposed to these medicines during pregnancy. Both groups experienced similar psychiatric morbidity. RESULTS: A total of 403 participants had evaluable data for these analyses (N = 279 exposed to SGAs; N = 124 controls). The mean pre-pregnancy weight, body mass index (BMI), and likelihood to begin pregnancy with an obese BMI were significantly higher in the exposed group compared to controls (p = 0.0003, p < 0.0001, and p < 0.0001 respectively), as were the mean weight and BMI at delivery (p < 0.0001). The mean weight gain did not differ significantly between groups. Across pre-pregnancy BMI categories, both groups gained more than the recommended amount of weight during pregnancy. CONCLUSION: We found that women exposed to SGAs began pregnancy with higher BMIs than controls. Both exposed and unexposed groups experienced similar weight gain during pregnancy. Strategies are needed to prevent excessive gestational weight gain and to reduce pre-pregnancy obesity in women with psychiatric disorders, especially those treated with SGAs.
Authors: Melissa M Batt; Aviva K Olsavsky; Shaleah Dardar; Celeste St John-Larkin; Rachel L Johnson; Mary D Sammel Journal: Curr Psychiatry Rep Date: 2022-02-15 Impact factor: 8.081
Authors: Stephanie M Eick; Michael Welton; Mechelle D Claridy; Skarlet G Velasquez; Nicholas Mallis; José F Cordero Journal: BMC Pregnancy Childbirth Date: 2020-10-07 Impact factor: 3.007