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Obstetrics & Gynecology
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name="wkhealth_journal_title" content="Obstetrics & Gynecology" /><meta name="wkhealth_journal_title_legacy" content="Obstetrics & Gynecology" /><meta name="wkhealth_issue" content="5" /><meta name="wkhealth_article_publication_date" content="May 2015" /><meta name="wkhealth_volume" content="125" /><meta name="wkhealth_ovid_accession_number" content="00006250-201505000-00033" /><meta name="wkhealth_issn" content="0029-7844" /><meta name="wkhealth_title" content="Obstetric and Neonatal Outcomes After Antipsychotic Medication Exposure in Pregnancy" /><meta name="wkhealth_authors" content="Coughlin, Catherine G.;Blackwell, Katherine A.;Bartley, Christine;Hay, Madeleine;Yonkers, Kimberly A.;Bloch, Michael H." /><meta name="wkhealth_doi" content="10.1097/AOG.0000000000000759" /><meta name="wkhealth_abstract_html_url" content="https://journals.lww.com/greenjournal/abstract/2015/05000/obstetric_and_neonatal_outcomes_after.33.aspx" /><meta name="wkhealth_fulltext_html_url" content="https://journals.lww.com/greenjournal/fulltext/2015/05000/obstetric_and_neonatal_outcomes_after.33.aspx" /><meta name="wkhealth_toc_section" content="Contents" /><meta name="wkhealth_toc_sub_section" content="Review" /><meta name="wkhealth_eJpId" content="greenjournal:2015:05000:00033" /><meta name="wkhealth_firstpage" content="1224" /><meta name="wkhealth_date" content="May 2015" /><meta name="wkhealth_pdf_url" content="https://journals.lww.com/greenjournal/_layouts/15/oaks.journals/downloadpdf.aspx?trckng_src_pg=Other&an=00006250-201505000-00033" /><meta name="Description" content="OBJECTIVE: Antipsychotic medications are used by increasing numbers of women of reproductive age." /><meta property="og:site_name" content="LWW" /><meta property="og:type" content="article" /><meta property="og:title" content="Obstetric and Neonatal Outcomes After Antipsychotic... : Obstetrics & Gynecology" /><meta property="og:description" content="sure to antipsychotics during pregnancy. DATA SOURCES: PubMed, Reprotox, and ClinicalTrials.gov were searched to identify potential studies for inclusion. METHODS OF STUDY SELECTION: Case–control or cohort studies estimating adverse birth outcomes associated with antipsychotic exposure during pregnancy were included. Pooled odds ratios (ORs) were used for dichotomous outcomes and weighted mean differences were used for neonatal birth weight and gestational age. Thirteen cohort studies, including 6,289 antipsychotic-exposed and 1,618,039 unexposed pregnancies, were included. TABULATION, INTEGRATION, AND RESULTS: Antipsychotic exposure was associated with an increased risk of major malformations (absolute risk difference [ARD] 0.03, 95% confidence interval [CI] 0.00–0.05, P=.04, Z=2.06), heart defects (ARD 0.01, 95% CI 0.00–0.01, P<.001, Z=3.44), preterm delivery (ARD 0.05, 95% CI 0.03–0.08, P<.001, Z=4.10), small-for-gestational-age births (ARD 0.05, 95% CI 0.02–0.09, P=.006, Z=2.74), elective termination (ARD 0.09, 95% CI 0.05–0.13, P<.001, Z=4.69), and decreased birth weight (weighted mean difference −57.89 g, 95% CI −103.69 to −12.10 g, P=.01). There was no significant difference in the risk of major malformations (test for subgroup differences: χ²=0.07, degrees of freedom=1, P=.79) between typical (OR 1.55, 95% CI 1.21–1.99, P=.006) and atypical (OR 1.39, 95% CI 0.66–2.93, P=.38) antipsychotic medications. Antipsychotic exposure was not associated with risk of large-for-gestational-age births, stillbirth, and spontaneous abortion. Although antipsychotic exposure during pregnancy was associated with increased risk of adverse obstetric and neonatal outcomes, this association does not necessarily imply causation. This analysis was limited by the small number of included studies and limited adjustment in studies for possible confounders. CONCLUSION: Women requiring antipsychotic treatment during pregnancy appear at higher risk of adverse birth outcomes, regardless of causation, and may benefit from close monitoring and minimization of other potential risk factors during pregnancy...." /><meta property="og:image" content="https://images.journals.lww.com/greenjournal/SocialThumb.00006250-201505000-00033.F1-33.jpeg" /><meta property="og:image:width" content="1192" /><meta property="og:image:height" content="502" /><meta property="og:url" content="https://journals.lww.com/greenjournal/fulltext/2015/05000/obstetric_and_neonatal_outcomes_after.33.aspx" /><meta property="twitter:card" content="summary" /><meta name="robots" content="index, follow, noarchive" /><meta name="WT.sv" content="ZUSE1PEJPWEB06" /><meta name="Title" content="Obstetrics & Gynecology" /><style id="SPThemeHideForms" type="text/css">body {opacity:0 !important}</style> <!-- Head container delegate control --> <link 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Obstet Gynecol 2015.</em>","https://images.journals.lww.com/greenjournal/Rollover.00006250-201505000-00033.F1-33.jpeg","https://images.journals.lww.com/greenjournal/Gallery.00006250-201505000-00033.F1-33.jpeg","https://journals.lww.com/greenjournal/_layouts/oaks.journals/ImageView.aspx?k=greenjournal:2015:05000:00033&i=F1-33&year=2015&issue=05000&article=00033&type=Abstract","https://images.journals.lww.com/greenjournal/Original.00006250-201505000-00033.F1-33.jpeg","/greenjournal/pages/imagegallery.aspx?year=2015&issue=05000&article=00033", "greenjournal_2015_05000_00033_F1-33");images["T1-33"]=new image("T1-33","T2-33","F1-33","Table 1-a","Characteristics of Included Studies","https://images.journals.lww.com/greenjournal/Rollover.00006250-201505000-00033.T1-33.jpeg","https://images.journals.lww.com/greenjournal/Gallery.00006250-201505000-00033.T1-33.jpeg","https://journals.lww.com/greenjournal/_layouts/oaks.journals/ImageView.aspx?k=greenjournal:2015:05000:00033&i=T1-33&year=2015&issue=05000&article=00033&type=Abstract","https://images.journals.lww.com/greenjournal/Original.00006250-201505000-00033.T1-33.jpeg","/greenjournal/pages/imagegallery.aspx?year=2015&issue=05000&article=00033", "greenjournal_2015_05000_00033_T1-33");images["T2-33"]=new image("T2-33","F2-33","T1-33","Table 1-b","Characteristics of Included Studies","https://images.journals.lww.com/greenjournal/Rollover.00006250-201505000-00033.T2-33.jpeg","https://images.journals.lww.com/greenjournal/Gallery.00006250-201505000-00033.T2-33.jpeg","https://journals.lww.com/greenjournal/_layouts/oaks.journals/ImageView.aspx?k=greenjournal:2015:05000:00033&i=T2-33&year=2015&issue=05000&article=00033&type=Abstract","https://images.journals.lww.com/greenjournal/Original.00006250-201505000-00033.T2-33.jpeg","/greenjournal/pages/imagegallery.aspx?year=2015&issue=05000&article=00033", "greenjournal_2015_05000_00033_T2-33");images["F2-33"]=new image("F2-33","F3-33","T2-33","","Risk of congenital malformations associated with antipsychotic exposure during pregnancy. Major congenital malformations or structural or functional abnormalities present at birth resulting in severe functional impairment, serious cosmetic defect, or death (<strong xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">A</strong>). Cardiac malformations (<strong xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">B</strong>). M-H, Mantel-Haenszel; CI, confidence interval.Fig. 2. <em xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">Coughlin. Antipsychotic Medications and Pregnancy Outcomes. Obstet Gynecol 2015.</em>","https://images.journals.lww.com/greenjournal/Rollover.00006250-201505000-00033.F2-33.jpeg","https://images.journals.lww.com/greenjournal/Gallery.00006250-201505000-00033.F2-33.jpeg","https://journals.lww.com/greenjournal/_layouts/oaks.journals/ImageView.aspx?k=greenjournal:2015:05000:00033&i=F2-33&year=2015&issue=05000&article=00033&type=Abstract","https://images.journals.lww.com/greenjournal/Original.00006250-201505000-00033.F2-33.jpeg","/greenjournal/pages/imagegallery.aspx?year=2015&issue=05000&article=00033", "greenjournal_2015_05000_00033_F2-33");images["F3-33"]=new image("F3-33","F4-33","F2-33","Fig. 3","Association of antipsychotic exposure during pregnancy with pregnancy outcome. Elective termination (<strong xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">A</strong>); spontaneous abortion, pregnancy loss early in gestation (<strong xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">B</strong>); and stillbirths, late pregnancy loss before completion of delivery (<strong xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">C</strong>). M-H, Mantel-Haenszel; CI, confidence interval.<em xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">Coughlin. Antipsychotic Medications and Pregnancy Outcomes. Obstet Gynecol 2015.</em>","https://images.journals.lww.com/greenjournal/Rollover.00006250-201505000-00033.F3-33.jpeg","https://images.journals.lww.com/greenjournal/Gallery.00006250-201505000-00033.F3-33.jpeg","https://journals.lww.com/greenjournal/_layouts/oaks.journals/ImageView.aspx?k=greenjournal:2015:05000:00033&i=F3-33&year=2015&issue=05000&article=00033&type=Abstract","https://images.journals.lww.com/greenjournal/Original.00006250-201505000-00033.F3-33.jpeg","/greenjournal/pages/imagegallery.aspx?year=2015&issue=05000&article=00033", "greenjournal_2015_05000_00033_F3-33");images["F4-33"]=new image("F4-33","F5-33","F3-33","Fig. 4","Premature births and low birth weight associated with antipsychotic exposure during pregnancy. Risk of preterm delivery, birth before 37 weeks of gestation (<strong xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">A</strong>), effect on mean gestational age (<strong xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">B</strong>), effect on mean neonatal birth weight (<strong xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">C</strong>), risk of small for gestational age (<strong xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">D</strong>), and risk of large for gestational age (<strong xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">E</strong>) associated with antipsychotic exposure during pregnancy. M-H, Mantel-Haenszel; CI, confidence interval; SD, standard deviation; IV, independent variable.<em xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">Coughlin. Antipsychotic Medications and Pregnancy Outcomes. Obstet Gynecol 2015.</em>","https://images.journals.lww.com/greenjournal/Rollover.00006250-201505000-00033.F4-33.jpeg","https://images.journals.lww.com/greenjournal/Gallery.00006250-201505000-00033.F4-33.jpeg","https://journals.lww.com/greenjournal/_layouts/oaks.journals/ImageView.aspx?k=greenjournal:2015:05000:00033&i=F4-33&year=2015&issue=05000&article=00033&type=Abstract","https://images.journals.lww.com/greenjournal/Original.00006250-201505000-00033.F4-33.jpeg","/greenjournal/pages/imagegallery.aspx?year=2015&issue=05000&article=00033", "greenjournal_2015_05000_00033_F4-33");images["F5-33"]=new image("F5-33","","F4-33","Fig. 5","Funnel plot examining publication bias in studies reporting preterm birth associated with antipsychotic exposure. Published reports (<em xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">circles</em>) are plotted for effect size and inverse standard error. The <em xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">diamond</em> represents the point estimate and 95% confidence interval (CI) of the odds ratio of preterm birth after antipsychotic exposure. The <em xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">line</em> indicates the 95% CI for the expected results of trials given this estimated underlying effect size.<em xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">Coughlin. Antipsychotic Medications and Pregnancy Outcomes. Obstet Gynecol 2015.</em>","https://images.journals.lww.com/greenjournal/Rollover.00006250-201505000-00033.F5-33.jpeg","https://images.journals.lww.com/greenjournal/Gallery.00006250-201505000-00033.F5-33.jpeg","https://journals.lww.com/greenjournal/_layouts/oaks.journals/ImageView.aspx?k=greenjournal:2015:05000:00033&i=F5-33&year=2015&issue=05000&article=00033&type=Abstract","https://images.journals.lww.com/greenjournal/Original.00006250-201505000-00033.F5-33.jpeg","/greenjournal/pages/imagegallery.aspx?year=2015&issue=05000&article=00033", "greenjournal_2015_05000_00033_F5-33"); return images; }function getPopupImageId() { return $get("ctl00_ctl29_g_60609907_a2fd_4137_90e7_52235148a2c7_ctl00_slideShowUserControl_popupImageId"); }function getIsExportToPPT() { return $get("ctl00_ctl29_g_60609907_a2fd_4137_90e7_52235148a2c7_ctl00_slideShowUserControl_IsExportToPPT"); }//]]> </script> <script src="/ScriptResource.axd?d=11ySqNT2t8wJXf-5ynqkHTYVaR0CZPUQDLhFk5-B61-yY4pHK9T4A-OmNoLERHX1OU2F3io32lKHXeNlvH0kpnJP6-ZQm2Ado5OlvNqUwB9TpwuIgMVQBgIz-DSVpHWqDoVFHrt69C9fSrbhF6t9QBuuAcSpa-p9_2de4EnR0aU1&t=2265eaa7" type="text/javascript"></script> <script src="/_layouts/15/blank.js?rev=6Epdi%2BEh0XOHrFNRcf4Cwg%3D%3DTAG0" type="text/javascript"></script> <script type="text/javascript"> //<![CDATA[ window.SPThemeUtils && SPThemeUtils.RegisterCssReferences([]); 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</div> </div> </div> </section> </div> </div> </div> </div> </div> <div id="ej-clear-float"> </div> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$ucUnsubscribeToAlertsUserControl$hiddenUnSubscribeAlertType" id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnSubscribeAlertType" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$ucUnsubscribeToAlertsUserControl$hiddenUnsubscribeJournalId" id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeJournalId" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$ucUnsubscribeToAlertsUserControl$hiddenUnsubscribeMessage" id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeMessage" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$ucUnsubscribeToAlertsUserControl$hiddenTopicalCollectionId" id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenTopicalCollectionId" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$ucUnsubscribeToAlertsUserControl$hiddenOvidId" id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenOvidId" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$ucUnsubscribeToAlertsUserControl$hiddenJournalId" id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId" /> <script type="text/javascript"> function alerts_ShowUnSubscribeeTOCPopup(title, alertType, journalId) { var unSubscribeeTocPopup = $find('unSubscribeToAlerts'); var lblUnsubscribeMessage = document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_lblUnsubscribeMessage'); lblUnsubscribeMessage.innerHTML = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnSubscribeAlertType').value = alertType; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeMessage').value = title; $('#' + 'ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_pUnsubscribeButtons').show(); if (document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId').value == null || document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId').value == '') { document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId').value = journalId; } if (unSubscribeeTocPopup != null) { unSubscribeeTocPopup.show(); } } function alerts_ShowUnSubscribeeTOCPopup_Root(title, journalId, alertType) { var unSubscribeeTocPopup = $find('unSubscribeToAlerts'); var lblUnsubscribeMessage = document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_lblUnsubscribeMessage'); lblUnsubscribeMessage.innerHTML = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeMessage').value = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnSubscribeAlertType').value = alertType; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeJournalId').value = journalId; $('#' + 'ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_pUnsubscribeButtons').show(); if (unSubscribeeTocPopup != null) { unSubscribeeTocPopup.show(); } } function alerts_ShowUnSubscribeeTOCPopup_Citation(title, journalId, ovidId) { var unSubscribeeTocPopup = $find('unSubscribeToAlerts'); var lblUnsubscribeMessage = document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_lblUnsubscribeMessage'); lblUnsubscribeMessage.innerHTML = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeMessage').value = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnSubscribeAlertType').value = 'Citation'; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeJournalId').value = journalId; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenOvidId').value = ovidId; $('#' + 'ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_pUnsubscribeButtons').show(); if (unSubscribeeTocPopup != null) { unSubscribeeTocPopup.show(); } } function alerts_ShowUnSubscribeeTOCPopup_Topical(title, journalId, topicalCollectionId) { var unSubscribeeTocPopup = $find('unSubscribeToAlerts'); var lblUnsubscribeMessage = document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_lblUnsubscribeMessage'); lblUnsubscribeMessage.innerHTML = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeMessage').value = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnSubscribeAlertType').value = 'Topical'; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeJournalId').value = journalId; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenTopicalCollectionId').value = topicalCollectionId; $('#' + 'ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_pUnsubscribeButtons').show(); if (document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId').value == null || document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId').value == '') { document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId').value = journalId; } if (unSubscribeeTocPopup != null) { unSubscribeeTocPopup.show(); } } function alerts_ShowUnSubscribeeTOCSuccessPopup() { var unSubscribeeTocPopup = $find('unSubscribeToAlerts'); if (unSubscribeeTocPopup != null) { unSubscribeeTocPopup.show(); } } $('.js-close').on('click', function() { var unSubscribeeTocPopup = $find('unSubscribeToAlerts'); if (unSubscribeeTocPopup != null) { unSubscribeeTocPopup.hide(); } return false; }); </script> <span id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_dummyTargetControl"></span> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$hiddenSubscribeToEtocPopupState" id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenSubscribeToEtocPopupState" value="showemail" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$hiddenConfirmSubscriptionPageUrl" id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenConfirmSubscriptionPageUrl" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$hiddenJournalId" id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenJournalId" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$hiddenSubscriptionType" id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenSubscriptionType" /> <div id="divPopupOverLay" class="Popup-Overlay" style="display: none; position: fixed; left: 0; top: 0; z-index: 3800; width: 1920px; height: 4517px;"></div> <div id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pnlSubscribeToEtoc" class="etoc-popup ej-box-modal-drop-shadow" style="display: none;"> <div tabindex="-1" role="dialog" class="wk-modal horizontally-centered small wk-modal-with-overlay wk-modal-small ejp-modal"> <div id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pnlMain" onkeypress="javascript:return WebForm_FireDefaultButton(event, 'ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_btnContinue')"> <section class="wk-modal-content"> <header class="wk-modal-header ejp-modal-header"> <div class="wk-modal-title ejp-modal-title"> <span id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_lblTitle"></span> </div> <button aria-label="close dialog" class="js-close primary-button wk-button-icon wk-modal-close ejp-modal-close "> <i class="fa fa-times"></i> </button> </header> <div class="wk-modal-body"> <div class="wk-field-item"> <div class="wk-field-body"> <strong> <span id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_lblThankYouMessage"></span></strong> </div> <div class="wk-field-body"> <span id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_cvEmailError" style="color:Black;display:none;"> <div class="ej-error-message"> <p class="ej-error-message-icon error-red"> </p> </div> </span> <label for="Email input">Enter your Email address:</label> <div class="wk-field-body"> <input name="ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$txtEmailAddress" type="text" id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_txtEmailAddress" class="ej-box-modal-style-1-input" /> </div> </div> <div class="wk-button-bar"> <div class="wk-button-group-left"> <input type="submit" name="ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$btnContinue" value="Continue" onclick="javascript:WebForm_DoPostBackWithOptions(new WebForm_PostBackOptions("ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$btnContinue", "", true, "", "", false, false))" id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_btnContinue" class="primary-button" /> <input type="button" value="Cancel" id="btnCancel" class="js-close secondary-button" /> </div> </div> </div> <div class="wk-field-item"> <div class="wk-field-body"> <a id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hypPrivacy" href="https://journals.lww.com/greenjournal/_layouts/oaks.journals/privacy.aspx" target="_blank">Privacy Policy</a> </div> </div> </div> </section> </div> <div id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pnlAuthenticatedUser" style="display: none;"> <section class="wk-modal-content"> <header class="wk-modal-header ejp-modal-header"> <div class="wk-modal-title ejp-modal-title"></div> <button aria-label="close dialog" class="js-close primary-button wk-button-icon wk-modal-close ejp-modal-close "><i class="fa fa-times"></i></button> </header> <div class="wk-modal-body"> <div class="wk-field-item"> <p> <strong> <span id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_lblAuthenticatedUserTitle"></span> </strong> </p> </div> <p id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pAuthenticatedUserMessage"> </p> </div> </section> </div> </div> </div> <div id="ej-clear-float"> </div> <script type="text/javascript"> function alerts_SaveSubscriptionTypeInHiddenField(url, subscriptionType, journalId, yearId, issueId, articleId) { if (journalId && yearId && issueId && articleId) { logCounterDataAlertWhenCitedSynchronously(journalId, yearId, issueId, articleId); } $('#' + 'ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenSubscriptionType').val(subscriptionType); $('#' + 'ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenJournalId').val(journalId); if (url) window.location = url; else __doPostBack('hypSubscribeToAlerts'); return false; } function alerts_ShowSubscribeeTOCPopup(journalTitle, journalId, subscriptionType, displaySubscriptionType) { $('#' + 'ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenSubscriptionType').val(subscriptionType); var subscribeToEtocPopup = $find('subscribeToEtoc'); subscribeToEtocPopup.show(); document.getElementsByTagName( 'html' )[0].classList.add('no-scroll'); var modelPopupState = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenSubscribeToEtocPopupState'); var emailTextBox = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_txtEmailAddress'); var thanksPanel = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pnlAuthenticatedUser'); var mainPanel = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pnlMain'); var thankYouMessageUnAuthenticated = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_lblThankYouMessage'); var thankYouMessageAuthenticated = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_lblAuthenticatedUserTitle'); if (!displaySubscriptionType) { displaySubscriptionType = subscriptionType; } if (modelPopupState.value == 'showthanksmessage') { thanksPanel.style.display = "block"; mainPanel.style.display = "none"; thankYouMessageAuthenticated.innerHTML = "Thank you for subscribing to the " + displaySubscriptionType + " for " + journalTitle + "."; } if (modelPopupState.value == 'showemail') { thanksPanel.style.display = "none"; mainPanel.style.display = "block"; thankYouMessageUnAuthenticated.innerHTML = "Thank you for choosing to subscribe to the " + displaySubscriptionType + " for " + journalTitle + "."; } if ($('.etoc-popup') != null) { document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenJournalId').value = journalId; if (modelPopupState.value == 'showemail') emailTextBox.focus(); } } $('.js-close').on('click', function () { document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_txtEmailAddress').value = ""; document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_cvEmailError').style.display = "none"; var pageUrl = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenConfirmSubscriptionPageUrl'); var subscribeeTocPopup = $find('subscribeToEtoc'); if (subscribeeTocPopup != null) { subscribeeTocPopup.hide(); document.getElementsByTagName( 'html' )[0].classList.remove('no-scroll'); if (pageUrl.value !== '' && pageUrl.value !== window.location.pathname) window.location = pageUrl.value; } return false; }); </script> <div id="ctl00_ctl51_Header_UserActionTools_eTocTopContainer"> <div id="eTocTop" style="display: none;"> <a rel="nofollow" title href="javascript:javascript: alerts_ShowSubscribeeTOCPopup('Obstetrics & Gynecology','greenjournal','eTOC', 'eTOC');;" onclick="javascript: alerts_ShowSubscribeeTOCPopup('Obstetrics & Gynecology','greenjournal','eTOC', 'eTOC');"><span id="ctl00_ctl51_Header_UserActionTools_alertLinkControlTop_defaultText" class="hideOnFixed">Subscribe to eTOC</span></a> </div> </div> <script> $(function () { //find recent searches link and move container var recentSearchesControl = $("a[id$='RecentSearches']"); if (recentSearchesControl.length) { recentSearchesControl.click(function (e) { e.stopPropagation(); if ($("#ResentSearchContainer").is(":hidden")) { $("#ResentSearchContainer").slideDown("slow"); recentSearchesControl.addClass('open'); } else { $("#ResentSearchContainer").hide(); recentSearchesControl.removeClass('open'); } }); } var eTocAccountLink = $("ul.js-user-action-toolbar__dropdown>li>a[id='SubscribeToEToc']"); if (eTocAccountLink.length) { eTocAccountLink.parent().html($("#eTocTop>a")); } }); </script> <a class="logo-secondary black" href="http://wolterskluwer.com/" target="_blank"> <h3 class="logo-secondary-text">Secondary Logo</h3> </a> <a href="#" class="sticky-search"><i class="fa fa-search"></i></a> </div> <div class="header__layout-bottom wk-grid-page-container"> <a id="hypJournals" class="logo-main" href="https://journals.lww.com/greenjournal/pages/default.aspx"> <h3 class="logo-main-text">Journal Logo </h3> </a> <div class="search-v2"> <div class="search-wrapper"> <select name="ctl00$ctl51$Header$SearchTopBoxControl$ddlContentScope" id="ctl00_ctl51_Header_SearchTopBoxControl_ddlContentScope"> <option value="All">All</option> <option selected="selected" value="Articles">Articles</option> <option value="Images">Images</option> <option value="Videos">Videos</option> <option value="Podcasts">Podcasts</option> <option value="Blogs">Blogs</option> </select> <div class="input-group" id="globalSearch"> <input name="ctl00$ctl51$Header$SearchTopBoxControl$txtKeywords" type="text" value="Search" id="ctl00_ctl51_Header_SearchTopBoxControl_txtKeywords" class="form-control searchText" /> <span class="input-group-btn"> <button id="ctl00_ctl51_Header_SearchTopBoxControl_btnGlobalSearchMagnifier" type="submit" class="btn btn-default"><i class="fa fa-search"></i></button> </span> <input type="hidden" name="ctl00$ctl51$Header$SearchTopBoxControl$IsAutoCompleteEnabled" id="ctl00_ctl51_Header_SearchTopBoxControl_IsAutoCompleteEnabled" value="true" /> <input type="hidden" name="ctl00$ctl51$Header$SearchTopBoxControl$AutocompleteApiUrl" id="ctl00_ctl51_Header_SearchTopBoxControl_AutocompleteApiUrl" value="https://platformservices.wolterskluwerhealth.com/autocomplete/OBSGY/shingle/" /> </div> </div> <div class="advance-search" style=""> <a id="ctl00_ctl51_Header_SearchTopBoxControl_lnkAdvanceSearch" href="https://journals.lww.com/greenjournal/pages/advancedsearch.aspx">Advanced Search</a> <input type="submit" name="ctl00$ctl51$Header$SearchTopBoxControl$btnGlobalSearch" value="" id="ctl00_ctl51_Header_SearchTopBoxControl_btnGlobalSearch" disabled="disabled" class="aspNetDisabled btnGlobalSearch" style="display: none;" /> <input name="ctl00$ctl51$Header$SearchTopBoxControl$hfldKeywords" type="hidden" id="ctl00_ctl51_Header_SearchTopBoxControl_hfldKeywords" class="hfldKeywords" value="disableButton" /> </div> </div> <script> $(function() { try { var objSearchBox = { btnGlobalSearchMagnifierId: 'ctl00_ctl51_Header_SearchTopBoxControl_btnGlobalSearchMagnifier', searchButtonId: 'ctl00_ctl51_Header_SearchTopBoxControl_btnGlobalSearch', txtKeywordsId: 'ctl00_ctl51_Header_SearchTopBoxControl_txtKeywords', hfldKeywordsHiddenId: 'ctl00_ctl51_Header_SearchTopBoxControl_hfldKeywords', defaultSearchText: 'Search' }; new Searchbox(objSearchBox).Init(); } catch (e) { console.error(e); } }); //autocomplete functionality for basic search //this functionality will call the SBA url and start suggesting after typing 3rd character var textKeywords = null; var hiddenAutocompleteApiUrl = null; var buttonGlobalSearch = null; $(function () { try { var objAutocomplete = { hiddenIsAutoCompleteEnabled: $('#ctl00_ctl51_Header_SearchTopBoxControl_IsAutoCompleteEnabled'), textKeywords: $('#ctl00_ctl51_Header_SearchTopBoxControl_txtKeywords'), hiddenAutocompleteApiUrl: $('#ctl00_ctl51_Header_SearchTopBoxControl_AutocompleteApiUrl'), buttonGlobalSearch: $('#ctl00_ctl51_Header_SearchTopBoxControl_btnGlobalSearch'), enableNewAutoComplete: true, newAutoCompleteUrl: 'https://dxg-search-na-prd.wkgposvc.cloud/Query.svc/Query_Expand', newAutoCompleteMaxSuggestions: '10', newAutoCompleteDictionaryIds: 'ovid_sted28_mesh22' }; autoComplete(objAutocomplete); } catch (e) { console.error(e); } }); $(function () { let searchSelect = $('select[id$="ddlContentScope"]');; if (searchSelect.length){ searchSelect.selectize(); } }); </script> </div> <div id="main-nav-container-v2"> <nav id="main-nav" class="navbar navbar-default yamm wk-grid-page-container"> <div class="navbar-header"> <button id="fatJuicy" type="button" class="navbar-hamburger-button navbar-toggle collapsed pull-left" data-bs-toggle="collapse" data-bs-target="#zz1_TopNavigationMenu" aria-expanded="false" aria-controls="navbar"> <span class="visually-hidden">Toggle navigation</span> <span class="icon-bar"></span> <span class="icon-bar"></span> <span class="icon-bar"></span> <span class="navbar-hamburger-button__text"></span> </button> </div> <div id="navActionButtons" class="btn-group navbar-hover-color" role="group" aria-label="..."> <a id="ctl00_ctl51_lnkSubscribe" class="btn btn-default navbar-button" href="https://shop.lww.com/p/0029-7844" target="_blank">Subscribe</a> <a id="ctl00_ctl51_lnkRegister" class="btn btn-default navbar-button" href="https://journals.lww.com/greenjournal/pages/register.aspx?ContextUrl=%2fgreenjournal%2fabstract%2f2015%2f05000%2fobstetric_and_neonatal_outcomes_after.33.aspx">Register</a> <button class="user-menu__link user-menu__link--login js-ejp-login-btn btn btn-default navbar-button" type="button" data-config="{"eventName":"login","eventDetail":{},"isNull":false}"> <span>Login</span> </button> </div> <div id="ctl00_ctl51_TopNavigationMenuConfiguration" style="display:none" class="js-top-navigation-menu-configuration" data-config="{"browsingHistory":{"isEnabled":true,"serviceUrl":"https://apim-hlrp-ejp-prod.azure-api.net/ee","pdfDownloadUrl":"/_layouts/15/oaks.journals/downloadpdf.aspx?trckng_src_pg=HistoryTab"}}"></div> <div id="zz1_TopNavigationMenu" class="navbar-collapse collapse js-top-navigation-menu noindex ms-core-listMenu-horizontalBox"> <ul id="zz2_RootAspMenu" class="root ms-core-listMenu-root static"> <li class="static dynamic-children"><span class="static dynamic-children menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode"><span aria-haspopup="true" class="additional-background ms-navedit-flyoutArrow dynamic-children"><span class="menu-item-text">Articles & Issues</span></span></span><ul aria-hidden="true" class="dynamic"> <li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/greenjournal/Pages/currenttoc.aspx" accesskey="1"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Current Issue</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/greenjournal/Pages/issuelist.aspx"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Previous Issues</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/greenjournal/toc/latest"><span 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'Obstetric and Neonatal Outcomes After Antipsychotic Medication Exposure in Pregnancy', '05012015', 'Catherine Coughlin, Katherine Blackwell, Christine Bartley, et al', '125', '5', '\u00A9 2015 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.', '00006250-201505000-00033', '', false, ''); } </script> <div id="ArticleContainer"> <article id="ej-abstract-view" xmlns:ssr="http://ssr-eus-go-csi.cloudapp.net/v1/assets" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xhtml="http://www.w3.org/1999/xhtml"><section class="ejp-r-article-subsection"><div class="ejp-r-article-subsection__text">Contents: Review</div></section><header class="ejp-article-header"><h1 class="ejp-article-title">Obstetric and Neonatal Outcomes After Antipsychotic Medication Exposure in Pregnancy</h1></header><section id="ejp-article-authors"><p id="P7">Coughlin, Catherine G. BS; Blackwell, Katherine A. MD, PhD; Bartley, Christine BA; Hay, Madeleine; Yonkers, Kimberly A. MD; Bloch, Michael H. MD, MS</p><section><a href="#" id="ejp-article-authors-link"> Author Information <i class="wk-icon-arrow-down-r"></i></a></section></section><section id="ejp-article-authors-info" class="ejp-article-authors-info ejp-article-authors-info--hidden"><div class="ejp-article-authors-info-holder"> <p id="AF_ID_d12744e96">Connecticut Mental Health Center, Yale Child Study Center, Yale University, and the Departments of Psychiatry and Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut.</p> <p id="BT_ID_d12744e102">Corresponding author: Catherine G. Coughlin, BS, Child Study Center, Yale University School of Medicine, PO Box 2070900, New Haven, CT 06520; e-mail: <span><a href="/cdn-cgi/l/email-protection#5a393b2e323f2833343f7439352f3d323633341a233b363f743f3e2f" onclick="javascript:window.open('mailto:catherine.coughlin@yale.edu');return false"><span class="__cf_email__" data-cfemail="30535144585542595e551e535f4557585c595e7049515c551e555445">[email protected]</span></a></span>.</p> <p id="BT_ID_d12744e102">Supported by the National Institutes of Health (NIH) grants K23MH09124 (M.H.B.) and T32MH019961 (K.A.B.), the AACAP/Eli Lilly Junior Investigator Award (M.H.B.), the Trichotillomania Learning Center (M.H.B.), Brain & Behavior Research Foundation (M.H.B.), the Rembrandt Foundation (M.H.B.), and UL1 RR024139 from the National Center for Research Resources, a component of the NIH, and NIH roadmap for Medical Research (M.H.B.).</p> <p id="BT_ID_d12744e102"><strong xmlns:mrws="http://webservices.ovid.com/mrws/1.0">Financial Disclosure</strong> The authors did not report any potential conflicts of interest.</p> </div></section><section id="article-journal-info"><div class="ej-journal-info"><span class="ej-journal-name">Obstetrics & Gynecology </span><span id="ej-journal-date-volume-issue-pg"><a href="/greenjournal/toc/2015/05000">125(5):p 1224-1235, May 2015.</a></span><span> | </span><span class="ej-journal-doi">DOI: </span>10.1097/AOG.0000000000000759</div></section><section id="ejp-article-indicators" class="ejp-article-indicators"><ul class="ejp-article-indicators__list"> <li id="ej-article-indicators-buy" class="ejp-article-indicators__list-item" onmouseover="javascript:Tooltip_Buy()" onmouseout="javascript:Tooltip_MouseOut()"><a href="#ContentAccessOptions"><span class="ejp-indicator">Buy</span></a></li> </ul><button id="openArticleMetricsPopupButton" type="button" class="wk-button wk-button-ghost wk-button-icon-left ejp-article-metrics-btn" data-articleMetricsEndpoint="//services.journals.lww.com/IntegrationServices/ArticleMetricsService.svc" data-articleMetricsDetailsUrl="https://wolterskluwer.altmetric.com/details/" data-doi="10.1097/AOG.0000000000000759" data-suiteId="vrs_woltere_journalsglobalvrs" data-articlePublicationDate="2015-05-01" data-articlePublicationDateString="May 2015" data-receivedDate="" data-revisionReceivedDate="" data-acceptedDate="" data-crossrefRefLinkRoot="https://doi.org/" data-medlineRefLinkRoot="http://www.ncbi.nlm.nih.gov/pubmed/" data-pubMedId="25932852"><i class="wk-icon-filled-chart-r"></i><i class="wk-icon-filled-chart-white-r"></i> Metrics </button></section><section class="ejp-article-tabs" id="abstractWrap"><div class="ejp-article-tabs__tablist" role="tablist" aria-label="Tabs"><button class="ejp-article-tabs__tablist-item" role="tab" aria-selected="false" aria-controls="panel1" id="tab1" tabIndex="0">Abstract</button><button class="ejp-article-tabs__tablist-item" role="tab" aria-selected="false" aria-controls="panel2" id="tab2" tabIndex="0">In Brief</button><hr class="ejp-article-tabs__tablist-slider" style="left: 0;"> </div> <div class="ejp-article-tabs__tabpanel" id="panel1" role="tabpanel" aria-labelledby="tab1"> <div id="article-abstract-content1"> <div class="ejp-article-text-abstract"> <h3>OBJECTIVE: </h3> <p>Antipsychotic medications are used by increasing numbers of women of reproductive age. The safety of these medications during pregnancy has not been well described. We undertook a systematic review and meta-analysis of the adverse obstetric and neonatal outcomes associated with exposure to antipsychotics during pregnancy.</p> <h3>DATA SOURCES: </h3> <p>PubMed, Reprotox, and <span><a href="http://ClinicalTrials.gov" onclick="javascript:window.open('http://ClinicalTrials.gov');return false">ClinicalTrials.gov</a></span> were searched to identify potential studies for inclusion.</p> <h3>METHODS OF STUDY SELECTION: </h3> <p>Case–control or cohort studies estimating adverse birth outcomes associated with antipsychotic exposure during pregnancy were included. Pooled odds ratios (ORs) were used for dichotomous outcomes and weighted mean differences were used for neonatal birth weight and gestational age. Thirteen cohort studies, including 6,289 antipsychotic-exposed and 1,618,039 unexposed pregnancies, were included.</p> <h3>TABULATION, INTEGRATION, AND RESULTS: </h3> <p>Antipsychotic exposure was associated with an increased risk of major malformations (absolute risk difference [ARD] 0.03, 95% confidence interval [CI] 0.00–0.05, <em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em>=.04, Z=2.06), heart defects (ARD 0.01, 95% CI 0.00–0.01, <em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em><.001, Z=3.44), preterm delivery (ARD 0.05, 95% CI 0.03–0.08, <em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em><.001, Z=4.10), small-for-gestational-age births (ARD 0.05, 95% CI 0.02–0.09, <em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em>=.006, Z=2.74), elective termination (ARD 0.09, 95% CI 0.05–0.13, <em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em><.001, Z=4.69), and decreased birth weight (weighted mean difference −57.89 g, 95% CI −103.69 to −12.10 g, <em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em>=.01). There was no significant difference in the risk of major malformations (test for subgroup differences: χ²=0.07, degrees of freedom=1, <em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em>=.79) between typical (OR 1.55, 95% CI 1.21–1.99, <em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em>=.006) and atypical (OR 1.39, 95% CI 0.66–2.93, <em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em>=.38) antipsychotic medications. Antipsychotic exposure was not associated with risk of large-for-gestational-age births, stillbirth, and spontaneous abortion. Although antipsychotic exposure during pregnancy was associated with increased risk of adverse obstetric and neonatal outcomes, this association does not necessarily imply causation. This analysis was limited by the small number of included studies and limited adjustment in studies for possible confounders.</p> <h3>CONCLUSION: </h3> <p>Women requiring antipsychotic treatment during pregnancy appear at higher risk of adverse birth outcomes, regardless of causation, and may benefit from close monitoring and minimization of other potential risk factors during pregnancy.</p> </div> </div> </div> <div class="ejp-article-tabs__tabpanel" id="panel2" role="tabpanel" aria-labelledby="tab2" hidden=""> <div id="article-abstract-content2"> <p>Antipsychotic exposure during pregnancy is associated with increased risk of adverse obstetric and neonatal outcomes.</p> </div> </div></section><section class="ej-article-copyright">© 2015 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. 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}); Sys.Application.add_init(function() { $create(AjaxControlToolkit.ModalPopupBehavior, {"BackgroundCssClass":"Popup-Overlay","DropShadow":true,"PopupControlID":"ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pnlSubscribeToEtoc","dynamicServicePath":"/greenjournal/pages/articleviewer.aspx","id":"subscribeToEtoc"}, null, null, $get("ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_dummyTargetControl")); }); document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_cvEmailError').dispose = function() { Array.remove(Page_Validators, document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_cvEmailError')); } g_QuickLaunchControlIds.push("zz1_TopNavigationMenu");_spBodyOnLoadFunctionNames.push('QuickLaunchInitDroppable'); var g_zz1_TopNavigationMenu = null; function init_zz1_TopNavigationMenu() { if (g_zz1_TopNavigationMenu == null) g_zz1_TopNavigationMenu = $create(SP.UI.AspMenu, null, null, null, $get('zz1_TopNavigationMenu')); } if(g_spPreFetchKeys) {{ g_spPreFetchKeys.push('SP.Core.js');}}EnsureScriptFunc('SP.Core.js', 'SP.UI.AspMenu', init_zz1_TopNavigationMenu); Sys.Application.add_init(function() { $create(AjaxControlToolkit.ModalPopupBehavior, {"BackgroundCssClass":"Popup-Overlay","PopupControlID":"ctl00_ctl29_g_60609907_a2fd_4137_90e7_52235148a2c7_ctl00_ucArticleTools_emailToColleagueControl_pnlEmailToColleague","dynamicServicePath":"/greenjournal/pages/articleviewer.aspx","id":"emailToColleaguePopupExtender__1847151704"}, null, null, $get("ctl00_ctl29_g_60609907_a2fd_4137_90e7_52235148a2c7_ctl00_ucArticleTools_emailToColleagueControl_hypEmailToColleague")); }); Sys.Application.add_init(function() { $create(AjaxControlToolkit.ModalPopupBehavior, {"BackgroundCssClass":"Popup-Overlay","PopupControlID":"ctl00_ctl29_g_60609907_a2fd_4137_90e7_52235148a2c7_ctl00_ucArticleTools_exportToCitationManager_pnlExportTo","dynamicServicePath":"/greenjournal/pages/articleviewer.aspx","id":"OpenExportToPopupExtender__1510475765"}, null, null, $get("ctl00_ctl29_g_60609907_a2fd_4137_90e7_52235148a2c7_ctl00_ucArticleTools_exportToCitationManager_hypExportToCitationManager")); }); Sys.Application.add_init(function() { $create(AjaxControlToolkit.ModalPopupBehavior, {"BackgroundCssClass":"Popup-Overlay","PopupControlID":"ctl00_ctl29_g_60609907_a2fd_4137_90e7_52235148a2c7_ctl00_emailToColleague_pnlEmailToColleague","dynamicServicePath":"/greenjournal/pages/articleviewer.aspx","id":"emailToColleaguePopupExtender_411447309"}, null, null, $get("ctl00_ctl29_g_60609907_a2fd_4137_90e7_52235148a2c7_ctl00_emailToColleague_hypEmailToColleague")); }); //]]> </script> </form> <span id="DeltaPlaceHolderUtilityContent"> </span> <script type="text/javascript">// <![CDATA[ var g_Workspace = "s4-workspace"; // ]]> </script> <div id="ctl00_ctl64_divAdConfig" data-adconfig="{"adTitle":"Advertisement","slotClass":"ad-slot-container","topBanner":{"sticky":"true","stickyDuration":"5000"},"lazyLoadingEnabled":false,"npiHash":"","pageTargeting":{"ArticleId":"00006250-201505000-00033"}}" data-videoadconfig="{"serverURL":"https://pubads.g.doubleclick.net/gampad/ads","sizes":"320x180|640x360","overlayUnitPath":"/15726702761/Desktop/greenjournal/Video/overlay","prerollUnitPath":"/15726702761/Desktop/greenjournal/Video/pre-roll","postrollUnitPath":"/15726702761/Desktop/greenjournal/Video/post-roll"}" class="js-ad-config"> </div> <div id="ctl00_ctl64_divScripts"><script type="text/plain" async="async" src="https://securepubads.g.doubleclick.net/tag/js/gpt.js" class="optanon-category-C0004"></script> <script type="text/javascript" src="https://lww.com/_layouts/15/oaks.journals/core/ads.js?v=05.24.00.023" defer="true"> </script> </div> <!-- Control to add scripts depending on settings from Configuration DB like --> <script type="text/javascript"> (function($) { if (true) { $(".top-microbar-container").addClass('top-microbar-container-moved').insertAfter(".advertisement-content_top"); } $(function () { if (false) { $( '<div class="top-banner-verify-email">Be sure to check your email to verify your new user account! 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