Association between Maternal Antipsychotic Use During Pregnancy and Neurodevelopmental disorders in the Neonate: A Systematic Review and Meta-Analysis

Background: The potential neurodevelopmental risks of intrauterine antipsychotic exposure remain unclear. This study synthesizes recent evidence to evaluate the association between maternal antipsychotic use during pregnancy and neurodevelopmental outcomes in offspring. Methods: A systematic search of PubMed, Embase, and Cochrane Library databases identified eligible RCTs and observational studies on neurodevelopmental consequences of prenatal antipsychotic exposure. Data were extracted, and study quality was appraised using the Newcastle-Ottawa Scale. Meta-analysis was conducted with RevMan 5.2, pooling data on neurophysiological outcomes using random-effects models. Risk and hazard ratios were the primary outcome measures. Results Nine eligible studies were included. Meta-analysis revealed a significant association between antipsychotic use during pregnancy and neurodevelopmental disorders (HR: 1.57; 95% CI: 1.35–1.83; p < 0.0001) and neuromotor disorders (RR: 1.81; 95% CI: 1.42–2.32; p < 0.00001). However, no significant association was observed for ASD (HR: 1.08; 95% CI: 0.93–1.26; p = 0.31) or ADHD (HR: 1.02; 95% CI: 0.89–1.18). Subgroup analyses confirmed consistent effect sizes across study designs and regions. Conclusion Maternal antipsychotic use during pregnancy is associated with a higher risk of neurodevelopmental and neuromotor disorders in offspring, though no significant link was found with ASD or ADHD.