Treating a woman with antipsychotic medications during pregnancy is tricky business. The connection between these drugs and pregnancy hasn’t been studied in depth so it’s difficult to anticipate how these meds might affect a developing fetus.

Medication during pregnancyProfessor Jayashri Kulkarni recently chose to tackle the problem. Kulkarni, director of the Monash Alfred Psychiatry Research Centre (MAPrc), led a team of researchers from the research center and Monash University in Melbourne. The researchers recruited pregnant women getting healthcare services provided by clinics in their home state, Victoria, as well as from clinics throughout all Australia’s states and territories. All the women were being treated with antipsychotic medications.

Australians taking prescription antipsychotic meds include men and women diagnosed with anxiety disorders, bipolar disorder, major depression, schizophrenia, and other psychiatric disorders. These illnesses affect the Australian population in these numbers:

  • 20% of all women will be diagnosed with depression at some point during their lives.
  • 10% of all men will be diagnosed with depression during their lifetime.
  • 25% of new mothers experience postnatal (postpartum) depression.
  • 20% of all women suffer severe menopausal depression.
  • 3% of both men and women are diagnosed with bipolar disorder.
  • 2% of both men and women are diagnosed with schizophrenia.
  • Women are treated for anxiety disorders at much higher rates than men.

When doctors see pregnant patients who take or need to take antipsychotic drugs, they face the dilemma of treating the mother at the risk of the baby or sparing the baby by not treating the mother. In many cases, not taking these medications as needed poses a bigger threat to both mother and child than taking them.

The Kulkarni study may ease the burden of prescription a bit. His study of 147 women involved follow-up interviews every six weeks during pregnancy and until 100 of their children were a year old.

Most of the babies born during the study were perfectly healthy but a good number of them (43%) did have the need for special care at birth. These babies were placed in neonatal intensive care units (NICUs) or special care nurseries (SCNs) at a rate three times higher than the national average. Reasons for special care included:

  • 37% exhibited symptoms of respiratory distress
  • 18% were delivered prematurely
  • 15% suffered withdrawal symptoms

The study highlights the need for doctors to “be particularly mindful of neonatal problems such as respiratory distress” when mom’s antipsychotic meds are taken during pregnancy. It does not, however, signal the need to forego these highly beneficial medications completely, according to Kulkarni. There is no evidence from Kulkarni’s study that these drugs produce physical or neurological abnormalities.

Source: Kulkarni, Jayashri, et al. “A Prospective Cohort Study of Antipsychotic Medications in Pregnancy: The First 147 Pregnancies and 100 OneYear Old Babies.” PLOS / One. PLOS. May 2, 2014. Web. Jun 15, 2014.