Pregnancy: an association between certain psychotropic medications and gestational diabetes

What the researchers studied

The authors searched PubMed, Scopus and Web of Science for studies on exposure to these medications during pregnancy and the development of gestational diabetes. The literature search covered publications available through June 2025.

The meta-analysis includes 21 observational studies and pools their adjusted relative risks. The abstract provided does not specify the total sample size, follow-up durations or the exact definition of the comparison groups. It therefore does not allow us to verify how similar the populations being compared were.

A stronger association for certain antipsychotics

For antipsychotics overall, the pooled adjusted relative risk is 1.43, with a 95% confidence interval of 1.17 to 1.69. For antidepressants, it is 1.19, with an interval of 1.10 to 1.27.

Second-generation antipsychotics show a stronger signal: the relative risk reaches 1.6, with a confidence interval of 1.23 to 1.97. No statistically significant association is reported for first-generation antipsychotics. However, this lack of a significant finding does not demonstrate an absence of risk.

These results are relative. Without the frequency of gestational diabetes in the comparison groups, which is missing from the abstract, it is impossible to translate these associations into a number of additional cases.

What these findings change—and what they do not

The observational nature of the studies prevents the association from being attributed with certainty to the medications themselves. The abstract does not detail the factors included in the adjustments or the differences between studies. Nor does it allow individual drugs to be compared.

The authors call for appropriate metabolic monitoring during pregnancy. These findings are not sufficient grounds for stopping or changing treatment: they should be discussed with the healthcare professional overseeing the pregnancy and the prescriber, taking into account the psychiatric condition being treated.

What we can take away

This review strengthens the case for individualized metabolic monitoring during pregnancy while taking psychotropic medications. It does not demonstrate causality or justify changing your treatment on your own.