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

Zixuan Wang; Andrew S.C. Yuen; Kirstie H.T.W. Wong; Adrienne Y.L. Chan; David Coghill; Emily Simonoff; Wallis C.Y. Lau; Ian C.K. Wong; Sohee Park; Kenneth K.C. Man

doi:10.1016/j.neubiorev.2024.105635

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

Zixuan Wang, Andrew S.C. Yuen, Kirstie H.T.W. Wong, Adrienne Y.L. Chan, David Coghill, Emily Simonoff, Wallis C.Y. Lau, Ian C.K. Wong, Sohee Park, Kenneth K.C. Man

Research output: Contribution to journal › Review article › peer-review

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.

Original language	English
Article number	105635
Number of pages	7
Journal	Neuroscience and Biobehavioral Reviews
Volume	160
Early online date	16 Mar 2024
DOIs	https://doi.org/10.1016/j.neubiorev.2024.105635
Publication status	Published - May 2024

Bibliographical note

Keywords

Antipsychotic
Autism spectrum disorder
Pregnancy
Attention-deficit/hyperactivity disorder

Access to Document

10.1016/j.neubiorev.2024.105635Licence: CC BY 4.0

Z Wang et al_Association between prenatal antipsychotic exposure and the risk of ADHD and autism spectrum disorder
Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC license (https://creativecommons.org/licenses/by-nc/4.0/).
Final published version, 1.55 MBLicence: CC BY-NC 4.0

Cite this

Wang, Z., Yuen, A. S. C., Wong, K. H. T. W., Chan, A. Y. L., Coghill, D., Simonoff, E., Lau, W. C. Y., Wong, I. C. K., Park, S., & Man, K. K. C. (2024). Association between prenatal antipsychotic exposure and the risk of attention-deficit/hyperactivity disorder and autism spectrum disorder: a systematic review and meta-analysis. Neuroscience and Biobehavioral Reviews, 160, Article 105635. https://doi.org/10.1016/j.neubiorev.2024.105635

@article{77b0704a6b5145068653a01b6ca97ab8,

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

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, Autism spectrum disorder, Pregnancy, Attention-deficit/hyperactivity disorder",

author = "Zixuan Wang and Yuen, {Andrew S.C.} and Wong, {Kirstie H.T.W.} and Chan, {Adrienne Y.L.} and David Coghill and Emily Simonoff and Lau, {Wallis C.Y.} and Wong, {Ian C.K.} and Sohee Park and Man, {Kenneth K.C.}",

note = "Copyright {\textcopyright} 2024 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC license (https://creativecommons.org/licenses/by-nc/4.0/).",

year = "2024",

month = may,

doi = "10.1016/j.neubiorev.2024.105635",

language = "English",

volume = "160",

journal = "Neuroscience and Biobehavioral Reviews",

issn = "0149-7634",

publisher = "Elsevier",

}

Wang, Z, Yuen, ASC, Wong, KHTW, Chan, AYL, Coghill, D, Simonoff, E, Lau, WCY, Wong, ICK , Park, S & Man, KKC 2024, 'Association between prenatal antipsychotic exposure and the risk of attention-deficit/hyperactivity disorder and autism spectrum disorder: a systematic review and meta-analysis', Neuroscience and Biobehavioral Reviews, vol. 160, 105635. https://doi.org/10.1016/j.neubiorev.2024.105635

Association between prenatal antipsychotic exposure and the risk of attention-deficit/hyperactivity disorder and autism spectrum disorder: a systematic review and meta-analysis. / Wang, Zixuan; Yuen, Andrew S.C.; Wong, Kirstie H.T.W. et al.
In: Neuroscience and Biobehavioral Reviews, Vol. 160, 105635, 05.2024.

Research output: Contribution to journal › Review article › peer-review

TY - JOUR

T1 - Association between prenatal antipsychotic exposure and the risk of attention-deficit/hyperactivity disorder and autism spectrum disorder: a systematic review and meta-analysis

AU - Wang, Zixuan

AU - Yuen, Andrew S.C.

AU - Wong, Kirstie H.T.W.

AU - Chan, Adrienne Y.L.

AU - Coghill, David

AU - Simonoff, Emily

AU - Lau, Wallis C.Y.

AU - Wong, Ian C.K.

AU - Park, Sohee

AU - Man, Kenneth K.C.

PY - 2024/5

Y1 - 2024/5

N2 - 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.

AB - 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.

KW - Antipsychotic

KW - Autism spectrum disorder

KW - Pregnancy

KW - Attention-deficit/hyperactivity disorder

UR - https://www.sciencedirect.com/science/article/pii/S0149763424001040

U2 - 10.1016/j.neubiorev.2024.105635

DO - 10.1016/j.neubiorev.2024.105635

M3 - Review article

C2 - 38499117

SN - 0149-7634

VL - 160

JO - Neuroscience and Biobehavioral Reviews

JF - Neuroscience and Biobehavioral Reviews

M1 - 105635

ER -

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

Abstract

Bibliographical note

Keywords

Access to Document

Other files and links

Fingerprint

Cite this