Pregnancy as a challenge for a patient with schizophrenia

Abstract

Introduction: Schizophrenia affects as many as 24 million people worldwide. Similar to the general population of women, it is estimated that every second woman with schizophrenia becomes a mother. The purpose of the article is to present the difficulties that pregnancy brings for women with schizophrenia in terms of physical and mental health and the course of the disease. Material and methods: The available literature in English and Polish languages was reviewed by searching the PubMed and Google Scholar databases. Articles published from 2009 to 2023 were selected using the following words: schizophrenia, pregnancy, hormones, treatment and outcomes. The analysis encompassed original studies, meta-analyses, randomized controlled trials, and review articles. Results: One of the most significant problems related to motherhood among patients with schizophrenia is the lack of access to knowledge about family planning, sexuality and parenting. Women with schizophrenia are more likely to engage in risky sexual contact, and usually their pregnancies are unplanned. The influence of schizophrenia on the course of pregnancy is still not clear. Studies show that changes in hormone levels during pregnancy, especially estrogen levels, play a protective role in the occurrence of schizophrenic episodes. Nonetheless, pregnant women with schizophrenia have higher risk of miscarriage, infant deaths, obesity, gestational diabetes, hypertension and other obstetric complications. Conclusions: Due to the fact that nowadays more women with schizophrenia may become mothers, it is crucial to provide patients with adequate knowledge about sexual and reproductive life and to ensure them professional, interdisciplinary medical and psychological care during pregnancy. Keywords: schizophrenia, pregnancy, hormones, treatment, outcomes