Abstract：
OBJECTIVE: Pregnant women with persistent schizophrenia and related disorders may require ongoing antipsychotic treatment, including clozapine. However, the potential risks of using clozapine during pregnancy and the postnatal period remain uncertain.
METHODS: We conducted a nested case-control study using the National Register of Antipsychotic Medication in Pregnancy (NRAMP) database. Our study assessed pregnancy outcomes among Australian women diagnosed with schizophrenia spectrum disorder and treated with clozapine (n = 14) during the first trimester. These women were compared to 2 subgroups: those treated with quetiapine (n = 53) and those not taking any medication (n = 24) during pregnancy.
RESULTS: We observed higher rates of miscarriage in the clozapine group compared to the quetiapine and drug-free groups. The clozapine group had a higher early pregnancy body mass index but lower overall pregnancy weight gain than the other groups. The prevalence of gestational diabetes was significantly higher in the clozapine group. The percentage of vaginal delivery was higher in the clozapine group than in the other 2 groups. Neonatal outcomes such as gestational age, and Apgar scores were similar across groups. The birth weight was lower in the clozapine group compared to the other 2 groups.
CONCLUSIONS: This study suggests that pregnant women taking clozapine and their babies have greater adverse outcomes compared to other groups. Clozapine appears to be associated with a greater risk of miscarriages, maternal gestational diabetes, and lower birth weight. However, the gestational age, Apgar scores, and admission to NICU/SCN were comparable between all groups.
METHODS: We conducted a nested case-control study using the National Register of Antipsychotic Medication in Pregnancy (NRAMP) database. Our study assessed pregnancy outcomes among Australian women diagnosed with schizophrenia spectrum disorder and treated with clozapine (n = 14) during the first trimester. These women were compared to 2 subgroups: those treated with quetiapine (n = 53) and those not taking any medication (n = 24) during pregnancy.
RESULTS: We observed higher rates of miscarriage in the clozapine group compared to the quetiapine and drug-free groups. The clozapine group had a higher early pregnancy body mass index but lower overall pregnancy weight gain than the other groups. The prevalence of gestational diabetes was significantly higher in the clozapine group. The percentage of vaginal delivery was higher in the clozapine group than in the other 2 groups. Neonatal outcomes such as gestational age, and Apgar scores were similar across groups. The birth weight was lower in the clozapine group compared to the other 2 groups.
CONCLUSIONS: This study suggests that pregnant women taking clozapine and their babies have greater adverse outcomes compared to other groups. Clozapine appears to be associated with a greater risk of miscarriages, maternal gestational diabetes, and lower birth weight. However, the gestational age, Apgar scores, and admission to NICU/SCN were comparable between all groups.
摘要：
目的：患有持续性精神分裂症和相关疾病的孕妇可能需要持续的抗精神病药物治疗，包括氯氮平.然而,孕期和产后使用氯氮平的潜在风险仍不确定.
方法：我们使用国家妊娠期抗精神病药物注册（NRAMP）数据库进行了嵌套病例对照研究。我们的研究评估了诊断为精神分裂症谱系障碍并在妊娠早期接受氯氮平治疗的澳大利亚女性（n=14）的妊娠结局。将这些妇女与两个亚组进行比较：在怀孕期间接受喹硫平治疗的妇女（n=53）和未服用任何药物的妇女（n=24）。
结果：我们观察到与喹硫平和无药组相比，氯氮平组的流产率更高。与其他组相比，氯氮平组的早期妊娠体重指数较高，但总体妊娠体重增加较低。氯氮平组妊娠期糖尿病的患病率明显较高。氯氮平组的阴道分娩百分比高于其他两组。新生儿结局，如胎龄，两组的Apgar评分相似。氯氮平组的出生体重低于其他两组。
结论：这项研究表明，与其他组相比，服用氯氮平的孕妇及其婴儿的不良结局更大。氯氮平似乎与更大的流产风险有关，孕妇妊娠期糖尿病，低出生体重。然而,胎龄,阿普加得分,和入院NICU/SCN在所有组之间具有可比性。
方法：我们使用国家妊娠期抗精神病药物注册（NRAMP）数据库进行了嵌套病例对照研究。我们的研究评估了诊断为精神分裂症谱系障碍并在妊娠早期接受氯氮平治疗的澳大利亚女性（n=14）的妊娠结局。将这些妇女与两个亚组进行比较：在怀孕期间接受喹硫平治疗的妇女（n=53）和未服用任何药物的妇女（n=24）。
结果：我们观察到与喹硫平和无药组相比，氯氮平组的流产率更高。与其他组相比，氯氮平组的早期妊娠体重指数较高，但总体妊娠体重增加较低。氯氮平组妊娠期糖尿病的患病率明显较高。氯氮平组的阴道分娩百分比高于其他两组。新生儿结局，如胎龄，两组的Apgar评分相似。氯氮平组的出生体重低于其他两组。
结论：这项研究表明，与其他组相比，服用氯氮平的孕妇及其婴儿的不良结局更大。氯氮平似乎与更大的流产风险有关，孕妇妊娠期糖尿病，低出生体重。然而,胎龄,阿普加得分,和入院NICU/SCN在所有组之间具有可比性。
