Domperidone Use in Lactation and Risk of Severe Postpartum Mental Health Outcomes
Bibliographic record
Abstract
OBJECTIVE: To evaluate whether postpartum domperidone use is associated with new-onset psychosis and other severe mental health outcomes. METHODS: We conducted a retrospective cohort study of people who filled a prescription for domperidone within 56 days of delivery between March 1, 2006, and March 1, 2022, in Ontario, Canada. Those who filled a domperidone prescription were matched 1:1 based on propensity score to an equal number of those who did not. The primary outcome was any health care contact for incident psychosis in the subsequent 365 days, with a secondary outcome of any psychiatric emergency department (ED) visit or hospitalization. Cox proportional hazards regression was used to compare outcome risk between people who initiated domperidone and those who did not. RESULTS: We identified 2,237,806 births, and 7,096 (0.3%) were followed by the individuals filling a publicly funded domperidone prescription within 56 days postpartum. After exclusions, 4,629 domperidone-exposed and 116,644 unexposed individuals remained. Overall, 4,585 domperidone-exposed individuals were propensity score matched to an equal number who were unexposed, resulting in good balance across all measured baseline characteristics. Compared with matched postpartum individuals who did not initiate domperidone, domperidone use was not associated with psychosis (6.4/1,000 person-years vs 6.4/1,000 person-years; hazard ratio [HR] 1.00, 95% CI, 0.60-1.67) in the postpartum period. We found no association between domperidone use and ED visits or hospital admissions with mental health diagnoses (38.0/1,000 person-years vs 43.4/1,000 person-years, HR 0.88, 95% CI, 0.71-1.08). CONCLUSION: Initiation of domperidone postpartum was not associated with an increased risk of new-onset psychosis or ED visits or hospital admissions with mental health diagnoses.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".