Abstract
Pregnant women constitute a vulnerable population, with 25.3% of pregnant women classified as suffering from a psychiatric disorder. Since childbearing age typically aligns with the onset of mental health disorders, it is of utmost importance to consider the effects that antipsychotic drugs have on pregnant women and their developing fetus. However, the induction of pharmacological treatment during pregnancy may pose significant risks to the developing fetus. Antipsychotics are typically introduced when the nonpharmacologic approaches fail to produce desired effects or when the risks outweigh the benefits from continuing without treatment or the risks from exposing the fetus to medication. Early studies of pregnant women with schizophrenia showed an increase in perinatal malformations and deaths among their newborns. Similar to schizophrenia, women with bipolar disorder have an increased risk of relapse in antepartum and postpartum periods. It is known that antipsychotic medications can readily cross the placenta, and exposure to antipsychotic medication during pregnancy is associated with potential teratogenicity. Potential risks associated with antipsychotic use in pregnant women include congenital abnormalities, preterm birth, and metabolic disturbance, which could potentially lead to abnormal fetal growth. The complex decision-making process for treating psychosis in pregnant women must evaluate the risks and benefits of antipsychotic drugs.
Highlights
Mental health disorders represent 7% of the global burden of disease [1]; the topic remains overlooked and, frequently, misjudged in society [2]
This review aims to evaluate (1) Antepartum psychiatric disorders, (2) Antipsychotics overview/classes, (3) Antipsychotics in pregnancy, and (4) Clinical studies to critically assess the teratogenicity, pregnancy complications, and postnatal risks associated with fetal exposure to antipsychotic treatment during pregnancy
It is known that antipsychotic medications can readily cross the placenta [54], and exposure to antipsychotic medication during pregnancy is associated with potential teratogenicity
Summary
Mental health disorders represent 7% of the global burden of disease [1]; the topic remains overlooked and, frequently, misjudged in society [2]. Recent WHO guidelines continue to emphasize its significance by highlighting the association between mental health disorders and poorer health outcomes [3]. Of pregnant women with a psychiatric disorder between 2006 and 2011, around 6% to 15% were prescribed antipsychotic medication [5]. Since childbearing age typically aligns with the onset of mental health disorders, it is of utmost importance to consider the effects that antipsychotic drugs have on the developing fetus. Conditions such as schizophrenia, bipolar disorder, and depression may require pharmacological intervention to manage the symptoms and to keep the patient and her fetus safe. The induction of pharmacological treatment during pregnancy may pose significant risks to the developing fetus
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