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Psychiatric disorders in pregnancy
Lori Levey1, Kimberly Ragan, Amy Hower-Hartley
1Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
Neurologic Clinics
|October 12, 2004
Summary
Psychiatric illness impacts pregnancy outcomes, but many treatments lack clear risks. Guidelines help minimize exposure to illness or medication during pregnancy for better maternal and infant health.
Area of Science:
- Obstetrics and Gynecology
- Psychiatry
- Pharmacology
Background:
- Psychiatric illness poses significant risks to pregnancy outcomes.
- Limited safety data exists for many psychiatric medications during pregnancy.
- Severe psychiatric conditions often require treatments with known teratogenic risks.
Purpose of the Study:
- To review the impact of psychiatric illness on obstetric outcomes.
- To provide clinical guidelines for managing psychiatric conditions during pregnancy.
- To inform decision-making regarding medication exposure versus illness exposure.
Main Methods:
- Review of existing literature on psychiatric illness and pregnancy.
- Development of a risk model for illness and treatment exposure during pregnancy.
- Formulation of clinical guidelines for managing reproductive-aged women.
Main Results:
- Psychiatric illness is a clear risk to pregnancy.
- Many psychiatric medications lack comprehensive safety data, but do not demonstrate clear risks.
- Medications for severe psychiatric illnesses carry the most significant risks.
Conclusions:
- Non-exposure to illness or treatment is not an option; decisions must weigh risks.
- Minimizing total exposure to both illness and medication is crucial.
- Guidelines include early pregnancy consideration, consistent medication use, dose monitoring, monotherapy preference, and utilizing online resources.