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Mood Disorders in Pregnancy

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Neurology and Psychiatry of Women

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Abstract

As one of the most common complications during pregnancy and the postpartum, perinatal mood disorders have become the subject of increasing attention and concern over the past decade. This growing awareness has led to new legislation at the local, national, and international levels as both patients and providers become more attuned to the impact of untreated perinatal mental illness on women and their families. Providing care for these patients is often of multidisciplinary concern because many women may not have a primary mental health provider and are instead seen by their obstetricians, internists, pediatricians, and family practitioners who then share in the burden of identifying and caring for these vulnerable women. In this chapter, we discuss the wide variation in mood changes women can experience, from the mild baby blues, which is not a discrete mood disorder, to perinatal depression and bipolar disorder as well as postpartum psychosis. We review the current literature and guidelines concerning screening pregnant and postpartum women, and we discuss unique treatment considerations for this population.

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Abbreviations

AAP:

American Academy of Pediatrics

ACOG:

American College of Obstetricians and Gynecologists

CBT:

Cognitive behavioral therapy

CRH:

Corticotropin-releasing hormone

EPDS:

Edinburgh Postnatal Depression Scale

ECT:

Electroconvulsive therapy

EEG:

Electroencephalography

EPS:

Extrapyramidal symptoms

FGAs:

First-generation antipsychotics

HPA:

Hypothalamic-Pituitary-Adrenal

IPT:

Interpersonal psychotherapy

MCMs:

Major congenital malformations

MDQ:

Mood Disorder Questionnaire

NMDA:

N-methyl-D-aspartate

PHQ:

Patient Health Questionnaire

PNAS:

Postnatal adaptation syndrome

RID:

Relative infant dose

SGAs:

Second generation antipsychotics

SSRIs :

Selective serotonin reuptake inhibitors

SNRIs:

Serotonin-norepinephrine reuptake inhibitors

TCAs:

Tricyclic antidepressants

WHO:

World Health Organization

References

  1. Ross LE, Murray BJ, Steiner M. Sleep and perinatal mood disorders: a critical review. J Psychiatry Neurosci. 2005;30(4):247–56.

    PubMed  PubMed Central  Google Scholar 

  2. Seyfried LS, Marcus SM. Postpartum mood disorders. Int Rev Psychiatry. 2003;15:231–42.

    Article  CAS  PubMed  Google Scholar 

  3. Meltzer-Brody S. New insights into perinatal depression: pathogenesis and treatment during pregnancy and postpartum. Dialogues Clin Neurosci. 2011;13:89–100.

    PubMed  PubMed Central  Google Scholar 

  4. Gavin N, Gaynes BN, Lohr K, Meltzer-Brody S, Gartlehner G, Swinson T. Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol. 2005;106(5):1071–83.

    Article  PubMed  Google Scholar 

  5. Chaudron LH. Complex challenges in treating depression during pregnancy. Am J Psychiatry. 2013;170:12–20.

    Article  PubMed  Google Scholar 

  6. Gaynes BN, Gavin N, Meltzer-Brody S, Lohr KN, Swinson T, Gartlehner G, et al. Perinatal depression: prevalence, screening accuracy, and screening outcomes: summary. Rockville: Agency for Healthcare Research and Quality (US); 2005.. 119 p.

    Google Scholar 

  7. Sharma V, Mazmanian D. Sleep loss and postpartum psychosis. Bipolar Disord. 2003;5(2):98–105.

    Article  PubMed  Google Scholar 

  8. Fisher J, de Mello MC, Patel V, Rahman A, Tran T, Holton S, et al. Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review. Bull World Health Organ. 2012;90:139–149G.

    Article  Google Scholar 

  9. Vesga-López O, Blanco C, Keyes K, Olfson M, Grant BF, Hasin DS. Psychiatric disorders in pregnant and postpartum women in the United States. Arch Gen Psychiatry. 2008;65(7):805–15.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Austin MP, Middleton P, Reilly NM, Highet NJ. Detection and management of mood disorders in the maternity setting: the Australian clinical practice guidelines. Women Birth. 2013;26(1):2–9.

    Article  PubMed  Google Scholar 

  11. Wisner KL, Sit DKY, McShea MC, Rizzo DM, Zoretich RA, Hughes CL, Eng HF, et al. Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings. JAMA Psychiat. 2013;70(5):490–8.

    Article  Google Scholar 

  12. Llewellyn AM, Stowe ZN, Nemeroff CB. Depression during pregnancy and the puerperium. J Clin Psychiatry. 1997;58(S15):26–32.

    PubMed  Google Scholar 

  13. Beck CT, Records K, Rice M. Further development of the postpartum depression predictors inventory-revised. J Obstet Gynecol Neonatal Nurs. 2006;35(6):735–45.

    Article  PubMed  Google Scholar 

  14. O’Hara MW, Wisner KL. Perinatal mental illness: definition, description and aetiology. Best Pract Res Clin Obstet Gynaecol. 2014;28:3–12.

    Article  PubMed  Google Scholar 

  15. Bloch M, Schmidt PJ, Danaceau M, Murphy J, Nieman L, Rubinow DR. Effects of gonadal steroids in women with a history of postpartum depression. Am J Psychiatry. 2000;157:924–30.

    Article  CAS  PubMed  Google Scholar 

  16. Bloch M, Daly RC, Rubinow DR. Endocrine factors in the etiology of postpartum depression. Compr Psychiatry. 2003;44:234–46.

    Article  PubMed  Google Scholar 

  17. Wisner KL, Stowe ZN. Psychobiology of postpartum mood disorders. Semin Reprod Endocrinol. 1997;15(1):77–89.

    Article  CAS  PubMed  Google Scholar 

  18. Chrousos GP, Torpy DJ, Gold PW. Interactions between the hypothalamic-pituitary-adrenal axis and the female reproductive system: clinical implications. Ann Intern Med. 1998;129(3):229–40.

    Article  CAS  PubMed  Google Scholar 

  19. Sit DK, Wisner KL. The identification of postpartum depression. Clin Obstet Gynecol. 2009;52(3):456–68.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Bansil P, Kuklina EV, Meikle SF, Posner SF, Kourtis AP, Ellington SR, et al. Maternal and fetal outcomes among women with depression. J Women’s Health. 2010;19(2):329–34.

    Article  Google Scholar 

  21. Andersson L, Sundström-Poromaa I, Wulff M, Åström M, Bixo M. Implications of antenatal depression and anxiety for obstetric outcome. Obstet Gynecol. 2004;104:467–76.

    Article  PubMed  Google Scholar 

  22. Chung TKH, Lau TK, Yip ASK, Chiu HFK, Lee DTS. Antepartum depressive symptomatology is associated with adverse obstetric and neonatal outcomes. Psychosom Med. 2001;63:830–4.

    Article  CAS  PubMed  Google Scholar 

  23. Wu J, Viguera A, Riley L, Cohen L, Ecker J. Mood disturbance in pregnancy and the mode of delivery. Am J Obstet Gynecol. 2002;187(4):864–7.

    Article  PubMed  Google Scholar 

  24. Davalos DB, Yadon CA, Tregellas HC. Untreated prenatal maternal depression and the potential risks to offspring: a review. Arch Womens Ment Health. 2012;15:1–14.

    Article  PubMed  Google Scholar 

  25. Dayan J, Creveuil C, Marks MK, Conroy S, Herlicoviez M, Dreyfus M, et al. Prenatal depression, prenatal anxiety, and spontaneous preterm birth: a prospective cohort study among women with early and regular care. Psychosom Med. 2006;68(6):938–46.

    Article  PubMed  Google Scholar 

  26. Field T, Diego M, Hernandez-Reif M. Prenatal depression effects on the fetus and newborn: a review. Infant Behav Dev. 2011;34(1):1–14.

    Article  PubMed  Google Scholar 

  27. Jarde A, Morais M, Kingston D, Giallo R, MacQueen GM, Giglia L, et al. Neonatal outcomes in women with untreated antenatal depression compared with women without depression: a systematic review and meta-analysis. JAMA Psychiat. 2016;73(8):826–37.

    Article  Google Scholar 

  28. Grigoriadis S, VonderPorten EH, Mamisashvili L, Tomlinson G, Dennis CL, Koren G, et al. The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and meta-analysis. J Clin Psychiatry. 2013;74(4):e321–41.

    Article  PubMed  Google Scholar 

  29. Lindahl V, Pearson JL, Colpe L. Prevalence of suicidality during pregnancy and the postpartum. Arch Womens Ment Health. 2005;8(2):77–87.

    Article  CAS  PubMed  Google Scholar 

  30. Mendez-Bustos P, Lopez-Castroman J, Baca-García E, Ceverino A. Life cycle and suicidal behavior among women. Sci World J. 2013;2013:485851.

    Article  Google Scholar 

  31. Schiff MA, Grossman DC. Adverse perinatal outcomes and risk for postpartum suicide attempt in Washington state, 1987–2001. Pediatrics. 2006;118(3):e669–75.

    Article  PubMed  Google Scholar 

  32. Cooper PJ, Murray L. Course and recurrence of postnatal depression. Evidence for the specificity of the diagnostic concept. Br J Psychiatry. 1995;166(2):191–5.

    Article  CAS  PubMed  Google Scholar 

  33. Alaräisänen A, Miettunen J, Pouta A, Isohanni M, Räsänen P, Mäki P. Ante- and perinatal circumstances and risk of attempted suicides and suicides in offspring: the Northern Finland birth cohort 1966 study. Soc Psychiatry Psychiatr Epidemiol. 2012;47(11):1783–94.

    Article  PubMed  Google Scholar 

  34. Bassett DL. Risk assessment and management in bipolar disorders. Med J Aust. 2010;193(4 Suppl):S21–3.

    PubMed  Google Scholar 

  35. Merikangas KR, Akiskal HS, Angst J, Greenberg PE, Hirschfeld RMA, Petukhova M, et al. Lifetime and 12-month prevalence of bipolar spectrum disorder in the national comorbidity survey replication. Arch Gen Psychiatry. 2007;64(5):543–52.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry. 2003;62:617–27.

    Article  Google Scholar 

  37. Yonkers KA, Wisner KL, Stowe Z, Leibenluft E, Cohen L, Miller L, et al. Management of bipolar disorder during pregnancy and the postpartum period. Am J Psychiatry. 2004;161(4):608–20.

    Article  PubMed  Google Scholar 

  38. Leibenluft E. Women with bipolar illness: clinical and research illness. Am J Psychiatry. 1996;153(2):163–73.

    Article  CAS  PubMed  Google Scholar 

  39. Freeman MP, Smith KW, Freeman SA, McElroy SL, Kmetz GF, Wright R, et al. The impact of reproductive events on the course of bipolar disorder. J Clin Psychiatry. 2002;63(4):284–7.

    Article  PubMed  Google Scholar 

  40. Grof P, Robbins W, Alda M, Berghoefer A, Vojtechovsky M, Nilsson A, et al. Protective effect of pregnancy in women with lithium-responsive bipolar disorder. J Affect Disord. 2000;61(1–2):31–9.

    Article  CAS  PubMed  Google Scholar 

  41. Munk-Olsen T, Laursen TM, Mendelson T, Pedersen CB, Mors O, Moretnsen PB. Risks and predictors of readmission for a mental disorder during the postpartum period. Arch Gen Psychiatry. 2009;66(2):189–95.

    Article  PubMed  Google Scholar 

  42. Viguera AC, Nonacs R, Cohen LS, Tondo L, Murray A, Baldessarini RJ. Risk of recurrence of bipolar disorder in pregnant and nonpregnant women after discontinuing lithium maintenance. Am J Psychiatry. 2000;157(2):179–84.

    Article  CAS  PubMed  Google Scholar 

  43. Viguera AC, Cohen LS. The course and management of bipolar disorder during pregnancy. Psychopharmacol Bull. 1998;23(3):339–46.

    Google Scholar 

  44. Viguera AC, Tondo L, Koukopoulos AE, Reginaldi D, Lepri B, Balderssarini RJ. Episodes of mood disorders in 2,252 pregnancies and postpartum periods. Am J Psychiatry. 2011;168(11):1179–85.

    Article  PubMed  Google Scholar 

  45. Viguera AC, Whitifield T, Baldessarini RJ, Newport DJ, Stowe Z, Reminick A, et al. Risk of recurrence in women with bipolar disorder during pregnancy: prospective study of mood stabilizer discontinuation. Am J Psychiatry. 2007;164(12):1817–24.

    Article  PubMed  Google Scholar 

  46. Harlow BL, Vitonis AF, Sparen P, Cnattingius S, Joffe H, Hultman CM. Incidence of hospitalization for postpartum psychotic and bipolar episodes in women with and without prior prepregnancy or prenatal psychiatric hospitalizations. Arch Gen Psychiatry. 2007;64(1):42–8.

    Article  PubMed  Google Scholar 

  47. Khan SJ, Fersh ME, Ernst C, Klipstein K, Albertini ES, Lusskin SI. Bipolar disorder in pregnancy and postpartum: principles of management. Curr Psychiatry Rep. 2016;18(2):13.

    Article  PubMed  Google Scholar 

  48. Akdeniz F, Vahip S, Pirildar S, Vahip I, Doganer I, Bulut I. Childbearing-related episodes in women with bipolar disorder. Psychopathology. 2003;36(5):234–8.

    Article  PubMed  Google Scholar 

  49. Blackmore ER, Rubinow DR, O’Connor TG, Liu X, Tang W, Craddock N, et al. Reproductive outcomes and risk of subsequent illness in women diagnosed with postpartum psychosis. Bipolar Disord. 2013;15(4):394–404.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Munk-Olsen T, Laursen TM, Meltzer-Brody S, Mortensen PB, Jones I. Psychiatric disorders with postpartum onset. Arch Gen Psychiatry. 2012;69(4):428–34.

    Article  PubMed  Google Scholar 

  51. Mitchell PB, Goodwin GM, Johnson GF, Hirschfeld RM. Diagnostic guidelines for bipolar depression: a probabilistic approach. Bipolar Disord. 2008;10(1 Pt 2):144–52.

    Article  PubMed  Google Scholar 

  52. Sharma V, Penava D. Screening for bipolar disorder during pregnancy and the postpartum period. J Obstet Gynaecol Can. 2010;32(3):278–81.

    Article  PubMed  Google Scholar 

  53. Clark CT, Sit DK, Driscoll K, Eng HF, Confer AL, Luther JF, Wisniewski SR, Wisner KL. Does screening with the MDQ and EPDS improve identification of bipolar disorder in an obstetrical sample? Depress Anxiety. 2015;32:518–26.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Heron J, Haque S, Oyebode F, Craddock N, Jones I. A longitudinal study of hypomania and depression symptoms in pregnancy and the postpartum period. Bipolar Disord. 2009;11(4):410–7.

    Article  PubMed  Google Scholar 

  55. Boden R, Lundgren M, Brandt L, Reutfors J, Andersen M, Kieler H. Risk of adverse pregnancy and birth outcomes in women treated or not treated with mood stabilisers for bipolar disorder: population based cohort study. BMJ. 2012;345:e7085.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Mei-Dan E, Ray JG, Vigod SN. Perinatal outcomes among women with bipolar disorder: a population-based study. Am J Obstet Gynecol. 2015;212(3):367e1–7.

    Article  Google Scholar 

  57. Rusner M, Berg M, Begley C. Bipolar disorder in pregnancy and childbirth: a systematic review of outcomes. BMC Pregnancy Childbirth. 2016;16(1):331.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Jablensky AV, Morgan V, Zubrick SR, Bower C, Yellachich LA. Pregnancy, delivery, and neonatal complications in a population cohort of women with schizophrenia and major affective disorders. Am J Psychiatry. 2005;162(1):79–91.

    Article  PubMed  Google Scholar 

  59. Lee HC, Lin HC. Maternal bipolar disorder increased low birthweight and preterm births: a nationwide population-based study. J Affect Disord. 2010;121(1–2):100–5.

    Article  PubMed  Google Scholar 

  60. Kendell RE, Chalmers JC, Platz C. Epidemiology of puerperal psychoses. Br J Psychiatry. 1987;150:662–73.

    Article  CAS  PubMed  Google Scholar 

  61. Terp IM, Mortensen PB. Clinical diagnoses and relative risk of admission after parturition. Br J Psychiatry. 1998;172:521–6.

    Article  CAS  PubMed  Google Scholar 

  62. Bergink V, Rasgon N, Wisner KL. Postpartum psychosis: madness, mania, and melancholic in motherhood. Am J Psychiatry. 2016;173(12):1179–88.

    Article  PubMed  Google Scholar 

  63. Jones I, Craddock N. Familiality of the puerperal trigger in bipolar disorder: results of a family study. Am J Psychiatry. 2001;158(6):913–7.

    Article  CAS  PubMed  Google Scholar 

  64. Jones I, Craddock N. Do puerperal psychotic episodes identify a more familial subtype of bipolar disorder? Results of a family history study. Psychiatr Genet. 2002;12(3):143–53.

    Article  Google Scholar 

  65. Chaudron LH, Pies RW. The relationship between postpartum psychosis and bipolar disorder: a review. J Clin Psychiatry. 2003;64(11):1284–92.

    Article  PubMed  Google Scholar 

  66. Videbech P, Gouliaev G. First admission with puerperal psychosis: 7–14 years of follow-up. Acta Psychiatr Scand. 1995;91(3):167–73.

    Article  CAS  PubMed  Google Scholar 

  67. Blackmore ER, Jones I, Doshi M, Haque S, Holder R, Brockington I, et al. Obstetric variables associated with bipolar affective puerperal psychosis. Br J Psychiatry. 2006;188:32–6.

    Article  PubMed  Google Scholar 

  68. Jones I, Chandra PS, Dazzan P, Howard LM. Bipolar disorder, affective psychosis, and schizophrenia is pregnancy and the post-partum period. Lancet. 2014;384:1789–99.

    Article  PubMed  Google Scholar 

  69. McNeil TF. A prospective study of postpartum psychoses in a high-risk group. Acta Psychiatr Scand. 1988;78(5):613–7.

    Article  CAS  PubMed  Google Scholar 

  70. Wesseloo R, Kamperman AM, Munk-Olsen T, Pop VJ, Kushner SA, Bergink V. Risk of postpartum relapse in bipolar disorder an postpartum psychosis: a systematic review and meta-analysis. Am J Psychiatry. 2016;173(2):117–27.

    Article  PubMed  Google Scholar 

  71. Robling SA, Paykel ES, Dunn VJ, Abbott R, Katona C. Long-term outcome of severe puerperal psychiatric illness: a 23 year follow-up study. Psychol Med. 2000;30:1263–71.

    Article  CAS  PubMed  Google Scholar 

  72. Kumar C, McIvor RJ, Davies T, Brown N, Papdopoulos A, Wieck A, et al. Estrogen administration does not reduce the rate of recurrence of affective psychosis after childbirth. J Clin Psychiatry. 2003;64(2):112–8.

    Article  CAS  PubMed  Google Scholar 

  73. Bergink V, Burgerhout KM, Weigelt K, Pop VJ, de Wit H, Drexhage RC, et al. Immune system dysregulation in first-onset postpartum psychosis. Biol Psychiatry. 2013;73(10):1000–7.

    Article  CAS  PubMed  Google Scholar 

  74. Bergink V, Kushner SA, Pop V, Kuijipens H, Lambregtse-van den Berg MP, Drehage RC, et al. Prevalence of autoimmune thyroid dysfunction in postpartum psychosis. Br J Psychiatry. 2011;198(4):262–8.

    Article  Google Scholar 

  75. Sharma V, Smith A, Khan M. The relationship between duration of labour, time of delivery, and puerperal psychosis. J Affect Disord. 2004;83(2–3):215–20.

    Article  PubMed  Google Scholar 

  76. Heron J, Blackmore ER, McGuinness M, Craddock N, Jones I. No ‘latent period’ in the onset of bipolar affective puerperal psychosis. Arch Womens Ment Health. 2007;10(2):79–81.

    Article  CAS  PubMed  Google Scholar 

  77. Heron J, McGuinness M, Blackmore ER, Craddock N, Jones I. Early postpartum symptoms in puerperal psychosis. BJOG. 2008;115(3):348–53.

    Article  CAS  PubMed  Google Scholar 

  78. Wisner KL, Peindl K, Hanusa BH. Symptomatology of affective and psychotic illness related to childbearing. J Affect Disord. 1994;30(2):77–87.

    Article  CAS  PubMed  Google Scholar 

  79. Oosthuizen P, Russouw H, Roberts M. Is puerperal psychosis bipolar mood disorder? A phenomenological comparison. Compr Psychiatry. 1995;36:77–81.

    Article  CAS  PubMed  Google Scholar 

  80. Brockington IF, Cernik KF, Schofield EM, Downing AR, Francis AF, Keelan C. Puerperal psychosis: phenomena and diagnosis. Arch Gen Psychiatry. 1981;38(7):829–33.

    Article  CAS  PubMed  Google Scholar 

  81. Spinelli MG. Postpartum psychosis: detection of risk and management. Am J Psychiatry. 2009;166(4):405–8.

    Article  PubMed  Google Scholar 

  82. Burgerhout KM, Kamperman AM, Roza SJ, Lambregtse-Van den Berg MP, Koorengevel KM, Hoogendijk WJ, et al. Functional recovery after postpartum psychosis: a prospective longitudinal study. J Clin Psychiatry. 2017;78(1):122–8.

    Article  PubMed  Google Scholar 

  83. Sit D, Rothschild AJ, Wisner KL. A review of postpartum psychosis. J Womens Health (Larchmt). 2006;15(4):352–68.

    Article  Google Scholar 

  84. Bergink V, Burgerhout KM, Koorengevel KM, Kamperman AM, Hoogendijk WJ, Labregtse-van den Berg MP, et al. Treatment of psychosis and mania in the postpartum period. Am J Psychiatry. 2015;172(2):115–23.

    Article  PubMed  Google Scholar 

  85. Rhodes AM, Segre LS. Perinatal depression: a review of US legislation and law. Arch Womens Ment Health. 2013;16:259–70.

    Article  PubMed  PubMed Central  Google Scholar 

  86. Haran C, van Driel M, Mitchell BL, Brodribb WE. Clinical guidelines for postpartum women and infants in primary care—a systematic review. BMC Pregnancy Childbirth. 2014;14:51.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Siu AL, US Preventive Services Task Force (USPSTF). Screening for depression in adults: US preventive services task force recommendation statement. JAMA. 2016;315:380–7.

    Article  CAS  PubMed  Google Scholar 

  88. American College of Obstetricians and Gynecologists Committee on Obstetric Practice. The American College of Obstetricians and Gynecologists Committee opinion no. 630. Screening for perinatal depression. Obstet Gynecol. 2015;125:1268–71.

    Article  Google Scholar 

  89. Earls MF, The Committee on Psychosocial Aspects of Child and Family Health. Clinical report: incorporating recognition and management of perinatal and postpartum depression into pediatric practice. Pediatrics. 2010;126:1032–9.

    Article  PubMed  Google Scholar 

  90. Liberto TL. Screening for depression and help-seeking in postpartum women during well-baby pediatric visits: an integrated review. J Pediatr Health Care. 2012;26:109–17.

    Article  PubMed  Google Scholar 

  91. Melville JL, Reed SD, Russo J, Croicu CA, Ludman E, LaRocco-Cockburn A, et al. Improving care for depression in obstetrics and gynecology: a randomized controlled trial. Obstet Gynecol. 2014;123:1237–46.

    Article  PubMed  PubMed Central  Google Scholar 

  92. Coverdale J, Roberts LW, Balon R, Beresin EV. Pedagogical implications of partnerships between psychiatry and obstetrics-gynecology in caring for patients with major mental disorders. Acad Psychiatry. 2015;39:430–6.

    Article  PubMed  Google Scholar 

  93. Boyd RC, Le HN, Somberg R. Review of screening instruments for postpartum depression. Arch Womens Ment Health. 2005;8(3):141–53.

    Article  CAS  PubMed  Google Scholar 

  94. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  95. Kroenke K, Spitzer RL, Williams JB. The patient health questionnaire-2: validity of a two-item depression screener. Med Care. 2003;41(11):1284–92.

    Article  PubMed  Google Scholar 

  96. Cox J, Holden J. Perinatal mental health: a guide to the Edinburgh postnatal depression scale (EPDS). Glasgow: Bell & Bain Ltd; 2003.

    Google Scholar 

  97. Gibson J, McKenzie-McHarg K, Shakespeare J, Price J, Gray R. A systematic review of studies validating the Edinburgh postnatal depression scale in antepartum and postpartum women. Acta Psychiatr Scand. 2009;119(5):350–64.

    Article  CAS  PubMed  Google Scholar 

  98. Hirschfeld RM, Williams JBW, Spitzer RL, Calabrese JR, Flynn L, Keck PE, Lewis L, McElroy SL, Post RM, Rapport DJ, Russell JM, Sachs GS, Zajecka J. Development and validation of a screening instrument for bipolar spectrum disorder: the mood disorder questionnaire. Am J Psychiatry. 2000;157(11):1873–5.

    Article  CAS  PubMed  Google Scholar 

  99. Finer LB, Zolna MR. Unintended pregnancy in the United States: incidence and disparities, 2006. Contraception. 2011;84(5):478–85.

    Article  PubMed  PubMed Central  Google Scholar 

  100. Einarson A, Selby P, Koren G. Abrupt discontinuation of psychotropic drugs during pregnancy: fear of teratogenic risk and impact of counselling. J Psychiatry Neurosci. 2001;26(1):44–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  101. Byatt N, Deligiannidis KM, Freeman MP. Antidepressant use in pregnancy: a critical review focused on risks and controversies. Acta Psychiatr Scand. 2013;127(2):94–114.

    Article  CAS  PubMed  Google Scholar 

  102. American Academy of Pediatrics Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2012;129(3):e827–41.

    Article  Google Scholar 

  103. World Health Organization. The optimal duration of exclusive breastfeeding: report of an expert consultation. Geneva: World Health Organization; 2001.. 10 p.

    Google Scholar 

  104. Tham EK, Tan J, Chong YS, Kwek K, Saw SM, Teoh OH, et al. Associations between poor subjective prenatal sleep quality and postnatal depression and anxiety symptoms. J Affect Disord. 2016;202:91–4.

    Article  PubMed  Google Scholar 

  105. Austin MP, Mitchell PB. Use of psychotropic medications in breastfeeding women: acute and prophylactic treatment. Aust N Z J Psychiatry. 1998;32(6):778–84.

    Article  CAS  PubMed  Google Scholar 

  106. Chad L, Pupco A, Bozzo P, Koren G. Update on antidepressant use during breastfeeding. Can Fam Physician. 2013;59(6):633–4.

    PubMed  PubMed Central  Google Scholar 

  107. Berle JO, Spigset O. Antidepressant use during breastfeeding. Curr Womens Health Rev. 2011;7(1):28–34.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  108. Lanza di Scalea T, Wisner KL. Antidepressant medication use during breastfeeding. Clin Obstet Gynecol. 2009;52(3):483–97.

    Article  PubMed  Google Scholar 

  109. Spinelli MG, Endicott J. Controlled clinical trial of interpersonal psychotherapy versus parenting education program for depressed pregnant women. Am J Psychiatry. 2003;160(3):555–62.

    Article  PubMed  Google Scholar 

  110. Andersen JT, Andersen NL, Horwitz H, Poulsen HE, Jimenez-Solem E. Exposure to selective serotonin reuptake inhibitors in early pregnancy and the risk of miscarriage. Obstet Gynecol. 2014;124(4):655–61.

    Article  CAS  PubMed  Google Scholar 

  111. Hemels ME, Einarson A, Koren G, Lanctôt KL, Einarson TR. Antidepressant use during pregnancy and the rates of spontaneous abortions: a meta-analysis. Ann Pharmacother. 2005;39(5):803–9.

    Article  PubMed  Google Scholar 

  112. Einarson A, Choi J, Einarson TR, Koren G. Rates of spontaneous and therapeutic abortions following use of antidepressants in pregnancy: results from a large prospective database. J Obstet Gynaecol Can. 2009;31(5):452–6.

    Article  PubMed  Google Scholar 

  113. Robinson GE. Psychopharmacology in pregnancy and postpartum. Focus. 2012;10:3–14.

    Article  Google Scholar 

  114. Jimenez-Solem E, Andersen JT, Petersen M, Broedbaek K, Lander AR, Afzal S, et al. SSRI use during pregnancy and risk of stillbirth and neonatal mortality. Am J Psychiatry. 2013;170(3):299–304.

    Article  PubMed  Google Scholar 

  115. Reefhuis J, Devine O, Friedman JM, Louik C, Honein MA. Specific SSRIs and birth defects: bayesian analysis to interpret new data in the context of previous reports. BMJ. 2015;351:h3190.

    Article  PubMed  PubMed Central  Google Scholar 

  116. Yonkers KA, Wisner KL, Stewart DE, Oberlander TF, Dell DL, Stotland N, et al. The management of depression during pregnancy: a report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists. Gen Hosp Psychiatry. 2009;31(5):403–13.

    Article  PubMed  PubMed Central  Google Scholar 

  117. Wogelius P, Nørgaard M, Gislum M, Pedersen L, Munk E, Mortensen PB, et al. Maternal use of selective serotonin reuptake inhibitors and risk of congenital malformations. Epidemiology. 2006;17(6):701–4.

    Article  PubMed  Google Scholar 

  118. Davis RL, Rubanowice D, McPhillips H, Raebel MA, Andrade SE, Smith D, HMO Research Network Center for Education, Research in Therapeutics, et al. Risks of congenital malformations and perinatal events among infants exposed to antidepressant medications during pregnancy. Pharmacoepidemiol Drug Saf. 2007;16(10):1086–94.

    Article  PubMed  Google Scholar 

  119. Wichman CL, Moore KM, Lang TR, St Sauver JL, Heise RH Jr, Watson WJ. Congenital heart disease associated with selective serotonin reuptake inhibitor use during pregnancy. Mayo Clin Proc. 2009;84(1):23–7.

    Article  PubMed  PubMed Central  Google Scholar 

  120. Källén BA, Otterblad Olausson P. Maternal use of selective serotonin re-uptake inhibitors in early pregnancy and infant congenital malformations. Birth Defects Res A Clin Mol Teratol. 2007;79(4):301–8.

    Article  CAS  PubMed  Google Scholar 

  121. Louik C, Lin AE, Werler MM, Hernandez-Diaz S, Mitchell AA. First-trimester use of selective serotonin-reuptake inhibitors and the risk of birth defects. N Engl J Med. 2007;356:2675–83.

    Article  CAS  PubMed  Google Scholar 

  122. Cole JA, Ephross SA, Cosmatos IS, Walker AM. Paroxetine in the first trimester and the prevalence of congenital malformations. Pharmacoepidemiol Drug Saf. 2007;16:1075–85.

    Article  PubMed  Google Scholar 

  123. Williams M, Wooltron E. Paroxetine (Paxil) and congenital malformations. CMAJ. 2005;173:1320–1.

    Article  PubMed  PubMed Central  Google Scholar 

  124. Wurst KE, Poole C, Ephross SA, Olshan AF. First trimester paroxetine use and the prevalence of congenital, specifically cardiac, defects: a meta-analysis of epidemiological studies. Birth Defects Res A Clin Mol Teratol. 2010;88:159–70.

    Article  CAS  PubMed  Google Scholar 

  125. Malm H, Artama M, Gissler M, Ritvanen A. Selective serotonin reuptake inhibiton and risk for major congenital anomalies. Obstet Gynecol. 2011;118:111–20.

    Article  PubMed  Google Scholar 

  126. Wisner KL, Sit DK, Hanusa BH, Moses-Kolko EL, Bogen DL, Hunker DF, et al. Major depression and antidepressant treatment: impact on pregnancy and neonatal outcomes. Am J Psychiatry. 2009;166(5):557–66.

    Article  PubMed  PubMed Central  Google Scholar 

  127. Wisner KL, Bogen DL, Sit D, McShea M, Hughes C, Rizzo D, et al. Does fetal exposure to SSRIs or maternal depression impact infant growth? Am J Psychiatry. 2013;170(5):485–93.

    Article  PubMed  PubMed Central  Google Scholar 

  128. Boukhris T, Sheehy O, Mottron L, Bérard A. Antidepressant use during pregnancy and the risk of autism spectrum disorder in children. JAMA Pediatr. 2016;170(2):117–24.

    Article  PubMed  Google Scholar 

  129. Brown HK, Ray JG, Wilton AS, Lunsky Y, Gomes T, Vigod SN. Association between serotonergic antidepressant use during pregnancy and autism spectrum disorder in children. JAMA. 2017;317(15):1544–52.

    Article  CAS  PubMed  Google Scholar 

  130. Clements CC, Castro VM, Blumenthal SR, Rosenfield HR, Murphy SN, Fava M, et al. Prenatal antidepressant exposure is associated with risk for attention-deficit hyperactivity disorder but not autism spectrum disorder in a large health system. Mol Psychiatry. 2015;20(6):727–34.

    Article  CAS  PubMed  Google Scholar 

  131. Croen LA, Grether JK, Yoshida CK, Odouli R, Hendrick V. Antidepressant use during pregnancy and childhood autism spectrum disorders. Arch Gen Psychiatry. 2011;68(11):1104–12.

    Article  PubMed  Google Scholar 

  132. Rai D, Lee BK, Dalman C, Golding J, Lewis G, Magnusson C. Parental depression, maternal antidepressant use during pregnancy, and risk of autism spectrum disorders: population based case-control study. BMJ. 2013;346:f2059.

    Article  PubMed  PubMed Central  Google Scholar 

  133. Sørensen MJ, Grønborg TK, Christensen J, Parner ET, Vestergaard M, Schendel D, et al. Antidepressant exposure in pregnancy and risk of autism spectrum disorders. Clin Epidemiol. 2013;5:449–59.

    Article  PubMed  PubMed Central  Google Scholar 

  134. Sujan AC, Rickert ME, Öberg AS, Quinn PD, Hernández-Díaz S, Almqvist C, et al. Associations of maternal antidepressant use during the first trimester of pregnancy with preterm birth, small for gestational age, autism spectrum disorder, and attention-deficit/hyperactivity disorder in offspring. JAMA. 2017;317(15):1553–62.

    Article  PubMed  PubMed Central  Google Scholar 

  135. Lorenzo L, Byers B, Einarson A. Antidepressant use in pregnancy. Expert Opin Drug Saf. 2011;10(6):883–9.

    Article  CAS  PubMed  Google Scholar 

  136. Chambers CD, Hernandez-Diaz S, Van Marter LJ, Werler MM, Louik C, Jones KL, et al. Selective serotonin-reuptake inhibitors and risk of persistent pulmonary hypertension of the newborn. New Engl J Med. 2006;354(6):579–87.

    Article  CAS  PubMed  Google Scholar 

  137. Occhiogrosso M, Omran SS, Altemus M. Persistent pulmonary hypertension of the newborn and selective serotonin reuptake inhibitors: lessons from clinical and translational studies. Am J Psychiatry. 2012;169(2):134–40.

    Article  PubMed  Google Scholar 

  138. Warburton W, Hertzman C, Oberlander TF. A register study of the impact of stopping third trimester selective serotonin reuptake inhibitor exposure on neonatal health. Acta Psychiatr Scand. 2010;121(6):471–9.

    Article  CAS  PubMed  Google Scholar 

  139. Hanley GE, Smolina K, Mintzes B, Oberlander TF, Morgan SG. Postpartum hemorrhage and use of serotonin reuptake inhibitor antidepressants in pregnancy. Obstet Gynecol. 2016;127(3):553–61.

    Article  CAS  PubMed  Google Scholar 

  140. Smit M, Wennink H, Heres M, Dolman KM, Honig A. Mirtazapine in pregnancy and lactation: data from a case series. J Clin Psychopharmacol. 2015;35(2):163–7.

    Article  CAS  PubMed  Google Scholar 

  141. Cole JA, Modell JG, Haight BR, Cosmatos IS, Stoler JM, Walker AM. Bupropion in pregnancy and the prevalence of congenital malformations. Pharmacoepidemiol Drug Saf. 2007;16(5):474–84.

    Article  CAS  PubMed  Google Scholar 

  142. Chun-Fai-Chan B, Koren G, Fayez I, Kalra S, Voyer-Lavigne S, Boshier A, et al. Pregnancy outcome of women exposed to bupropion during pregnancy: a prospective comparative study. Am J Obstet Gynecol. 2005;192(3):932–6.

    Article  CAS  PubMed  Google Scholar 

  143. Louik C, Kerr S, Mitchell AA. First-trimester exposure to bupropion and risk of cardiac malformations. Pharmacoepidemiol Drug Saf. 2014;23(10):1066–75.

    Article  CAS  PubMed  Google Scholar 

  144. Einarson A, Bonari L, Voyer-Lavigne S, Addis A, Matsui D, Johnson Y, et al. A multicentre prospective controlled study to determine the safety of trazodone and nefazodone use during pregnancy. Can J Psychiatr. 2003;48(2):106–10.

    Article  Google Scholar 

  145. Einarson A, Choi J, Einarson TR, Koren G. Incidence of major malformations in infants following antidepressant exposure in pregnancy: results of a large prospective cohort study. Can J Psychiatr. 2009;54(4):242–6.

    Article  Google Scholar 

  146. Misri S, Sivertz K. Tricyclic drugs in pregnancy and lactation: a preliminary report. Int J Psychiatry Med. 1991;21(2):157–71.

    Article  CAS  PubMed  Google Scholar 

  147. Osborne LM, Birndorf CA, Szkodny LE, Wisner KL. Returning to tricyclic antidepressants for depression during childbearing: clinical and dosing challenges. Arch Womens Ment Health. 2014;17(3):239–46.

    Article  PubMed  PubMed Central  Google Scholar 

  148. Altshuler LL, Cohen L, Szuba MP, Burt VK, Gitlin M, Mintz J. Pharmacologic management of psychiatric illness during pregnancy: dilemmas and guidelines. Am J Psychiatry. 1996;153(5):592–606.

    Article  CAS  PubMed  Google Scholar 

  149. Wisner KL, Perel JM, Wheeler SB. Tricyclic dose requirements across pregnancy. Am J Psychiatry. 1993;150(10):1541–2.

    Article  CAS  PubMed  Google Scholar 

  150. Cipriani A, Pretty H, Hawton K, Geddes JR. Lithium in the prevention of suicidal behavior and all-cause mortality in patients with mood disorders: a systematic review of randomized trials. Am J Psychiatry. 2005;162(10):1805–19.

    Article  PubMed  Google Scholar 

  151. Deligiannidis KM. Therapeutic drug monitoring in pregnant and postpartum women: recommendations for SSRIs, lamotrigine, and lithium. J Clin Psychiatry. 2010;71(5):649–50.

    Article  CAS  PubMed  Google Scholar 

  152. Bergink V, Kushner SA. Lithium during pregnancy. Am J Psychiatry. 2014;171(7):712–5.

    Article  PubMed  Google Scholar 

  153. Weinstein MR, Goldfield M. Cardiovascular malformations with lithium use during pregnancy. Am J Psychiatry. 1975;132(5):529–31.

    Article  CAS  PubMed  Google Scholar 

  154. Schou M, Goldfield MD, Weinstein MR, Villeneuve A. Lithium and pregnancy—I. Report from the register of lithium babies. Br Med J. 1973;2(5859):135–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  155. Kallen B, Tandberg A. Lithium and pregnancy. A cohort study on manic-depressive women. Acta Psychiatr Scand. 1983;68(2):134–9.

    Article  CAS  PubMed  Google Scholar 

  156. Jacobson SJ, Jones K, Johnson K, Ceolin L, Kaur P, Sahn D, Donnenfeld AE, et al. Prospective multicenter study of pregnancy outcome after lithium exposure during first trimester. Lancet. 1992;339(8792):530–3.

    Article  CAS  PubMed  Google Scholar 

  157. Diav-Citrin O, Shechtman S, Tahover E, Finkel-Pekarsky V, Arnon J, Kennedy D, et al. Pregnancy outcome following in utero exposure to lithium: a prospective, comparative, observational study. Am J Psychiatry. 2014;171(7):785–94.

    Article  PubMed  Google Scholar 

  158. Patorno E, Huybrechts KF, Bateman BT, Cohen JM, Desai RJ, Mogun H, et al. Lithium use in pregnancy and the risk of cardiac malformations. NEJM. 2017;376(23):2245–54.

    Article  CAS  PubMed  Google Scholar 

  159. Mizrahi EM, Hobbs JF, Goldsmith DI. Nephrogenic diabetes insipidus in transplacental lithium intoxication. J Pediatr. 1979;94(3):493–5.

    Article  CAS  PubMed  Google Scholar 

  160. Pinelli JM, Symington AJ, Cunningham KA, Paes BA. Case report and review of perinatal implications of maternal lithium use. Am J Obstet Gynecol. 2002;197:245–9.

    Article  Google Scholar 

  161. Newport DJ, Viguera AC, Beach AJ, Ritchie JC, Cohen LS, Stowe ZN. Lithium placental passage and obstetrical outcome: implications for clinical management during late pregnancy. Am J Psychiatry. 2005;162(11):2162–70.

    Article  PubMed  Google Scholar 

  162. Cheschier N, American College of Obstetrics and Gynecologists (ACOG) Committee on Practice Bulletins-Obstetrics. Neural tube defects. Int J Gynaecol Obstet. 2003;83(1):123–33.

    Article  PubMed  Google Scholar 

  163. Bowden CL, Calabrese JR, Sachs G, Yatham LN, Asghar SA, Hompland M, Montgomery P, Earl N, Smoot TM, DeVeaugh-Geiss J, Lamictal 606 Study Group. A placebo-controlled 18-month trial of lamotrigine and lithium maintenance treatment in recently manic or hypomanic patients with bipolar I disorder. Arch Gen Psychiatry. 2003;60(4):392–400.

    Article  CAS  PubMed  Google Scholar 

  164. Clark CT, Klein AM, Perel JM, Helsel J, Wisner KL. Lamotrigine dosing for pregnant patients with bipolar disorder. Am J Psychiatry. 2013;170(11):1240–7.

    Article  PubMed  PubMed Central  Google Scholar 

  165. Morrow J, Russell A, Guthrie E, Parsons L, Robertson I, Waddell R, et al. Malformation risks of antiepileptic drugs in pregnancy: a prospective study from the UK Epilepsy and Pregnancy Register. J Neurol Neurosurg Psychiatry. 2006;77(2):193–8.

    Article  CAS  PubMed  Google Scholar 

  166. Holmes LB, Baldwin EJ, Smith CR, Habecker E, Glassman L, Wong SL, et al. Increased frequency of isolated cleft palate in infants exposed to lamotrigine during pregnancy. Neurology. 2008;70(22):2152–8.

    Article  CAS  PubMed  Google Scholar 

  167. Tennis P, Eldridge RR, International Lamotrigine Pregnancy Registry Scientific Advisory Committee. Preliminary results on pregnancy outcomes in women using lamotrigine. Epilepsia. 2002;43(10):1161–7.

    Article  CAS  PubMed  Google Scholar 

  168. Cunnington M, Tennis P, International Lamotrigine Pregnancy Registry Scientific Advisory Committee. Lamotrigine and the risk of malformations in pregnancy. Neurology. 2005;64(6):955–60.

    Article  CAS  PubMed  Google Scholar 

  169. Weston J, Bromley R, Jackson CF, Adab N, Clayton-Smith J, Greenhalgh J, et al. Monotherapy treatment of epilepsy in pregnancy: congenital malformation outcomes in the child. Cochrane Database Syst Rev. 2016;11(CD010224):1–348.

    Google Scholar 

  170. Banach R, Boskovic R, Einarson T, Koren G. Long-term developmental outcome of children of women with epilepsy, unexposed or exposed prenatally to antiepileptic drugs: a meta-analysis of cohort studies. Drug Saf. 2010;33(1):73–9.

    Article  CAS  PubMed  Google Scholar 

  171. Iqbal MM, Sohhan T, Mahmud SZ. The effects of lithium, valproic acid, and carbamazepine during pregnancy and lactation. J Toxicol Clin Toxicol. 2001;39(4):381–92.

    Article  CAS  PubMed  Google Scholar 

  172. Meador K, Reynolds MW, Crean S, Fahrback K, Probst C. Pregnancy outcomes in women with epilepsy: a systematic review and meta-analysis of published pregnancy registries and cohorts. Epilepsy Res. 2008;81(1):1–13.

    Article  PubMed  PubMed Central  Google Scholar 

  173. Joffe H, Cohen LS, Suppes T, Hwang CH, Molay F, Adams JM, Sachs GS, Hall JE. Longitudinal follow-up of reproductive and metabolic features of valproate-associated polycystic ovarian syndrome features: a preliminary report. Biol Psychiatry. 2006;60(12):1378–81.

    Article  CAS  PubMed  Google Scholar 

  174. Chen CY, Li X, Ma LY, Zhou Y, Feng Q, Cui YM. In utero oxcarbazepine exposure and neonatal abstinence syndrome: case report and brief review of literature. Pharmacotherapy. 2017;37(7):e71–5.

    Article  PubMed  PubMed Central  Google Scholar 

  175. Hayes J, Prah P, Nazareth I, King M, Walters K, Petersen I, et al. Prescribing trends in bipolar disorder: cohort study in the United Kingdom THIN primary care database 1995–2009. PLoS One. 2011;6(12):e28725.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  176. Cohen LS, Viguera AC, McInerney KA, Freeman MP, Sosinsky AZ, Moustafa D, et al. Reproductive safety of second-generation antipsychotics: current data from the Massachusetts General Hospital National Pregnancy Registry for Atypical Antipsychotics. Am J Psychiatry. 2016;172(3):263–70.

    Article  Google Scholar 

  177. Habermann F, Fritzsche J, Fuhlbruck F, Wacker E, Alignol A, Weber-Schoendorfer C, et al. Atypical antipsychotic drugs and pregnancy outcome: a prospective, cohort study. J Clin Psychopharmacol. 2013;33(4):453–62.

    Article  CAS  PubMed  Google Scholar 

  178. Coughlin CG, Blackwell KA, Bartley C, Hay M, Yonkers KA, Bloch MH. Obstetric and neonatal outcomes after antipsychotic medication exposure in pregnancy. Obstet Gynecol. 2015;125(5):1224–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  179. Ennis ZN, Damkier P. Pregnancy exposure to olanzapine, quetiapine, risperidone, aripiprazole and risk of congenital malformations. A systematic review. Basic Clin Pharmacol Toxicol. 2015;116(4):315–20.

    Article  CAS  PubMed  Google Scholar 

  180. McKenna K, Korea G, Tetelbaum M, Wilton L, Shakir S, Diav-Citrin O, et al. Pregnancy outcome of women using atypical antipsychotic drugs: a prospective comparative study. J Clin Psychiatry. 2005;66(4):444–9.

    Article  CAS  PubMed  Google Scholar 

  181. Reis M, Kallen B. Maternal use of antipsychotics in early pregnancy and delivery outcome. J Clin Psychopharmacol. 2008;28(3):279–88.

    Article  CAS  PubMed  Google Scholar 

  182. Tosato S, Albert U, Tomassi S, Iasevoli F, Carmassi C, Ferrari S, et al. A systematized review of atypical antipsychotics in pregnant women: balancing between risks of untreated illness and risks of drug-related adverse effects. J Clin Psychiatry. 2017;78(5):e477–89.

    Article  PubMed  Google Scholar 

  183. United States Food and Drug Administration. FDA Drug Safety Communication: antipsychotic drug labels updated on use during pregnancy and risk of abnormal muscle movements and withdrawal symptoms in newborns. Washington (US). United States Food and Drug Administration; 2011.

    Google Scholar 

  184. Fortinguerra F, Clavenna A, Bonati M. Psychotropic drug use during breastfeeding: a review of the evidence. Pediatrics. 2009;124(4):e547–56.

    Article  PubMed  Google Scholar 

  185. Chaudron LH, Schoenecker CJ. Bupropion and breastfeeding: a case of a possible infant seizure. J Clin Psychiatry. 2004;65(6):881–2.

    Article  PubMed  Google Scholar 

  186. Neuman G, Colantonio D, Delaney S, Szynkaruk M, Ito S. Bupropion and escitalopram during lactation. Ann Pharmacother. 2014;48(7):928–31.

    Article  PubMed  Google Scholar 

  187. Pennell PB, Gidal BE, Sabers A, Gordon J, Perucca E. Pharmacology of antiepileptic drugs during pregnancy and lactation. Epilepsy Behav. 2007;11(3):263–9.

    Article  PubMed  Google Scholar 

  188. Newport DJ, Pennell PB, Calamaras MR, Ritchie JC, Newman M, Knight B, et al. Lamotrigine in breast milk and nursing infants: determination of exposure. Pediatrics. 2008;122(1):e223–31.

    Article  PubMed  PubMed Central  Google Scholar 

  189. Ohman I, Vitols S, Tomson T. Lamotrigine in pregnancy: pharmacokinetics during delivery, in the neonate and during lactation. Epilepsia. 2000;41(6):709–13.

    Article  CAS  PubMed  Google Scholar 

  190. Schou M, Amdisen A. Lithium and pregnancy – III, lithium ingestion by children breast-fed by women on lithium treatment. BMJ. 1973;2(5859):138.

    Article  CAS  PubMed  Google Scholar 

  191. Wisner KL, Perel JM. Serum levels of valproate and carbamazepine in breastfeeding mother-infant pairs. J Clin Psychopharmacol. 1998;18(2):167–9.

    Article  CAS  PubMed  Google Scholar 

  192. Kaneko S, Sato T, Suzuki K. The levels of anticonvulsants in breast milk. Br J Clin Pharmacol. 1979;7(6):624–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  193. Viguera AC, Newport DJ, Ritchie J, Stowe Z, Whitfield T, Mogielnicki J, et al. Lithium in breast milk and nursing infants: clinical implications. Am J Psychiatry. 2007;164(2):342–5.

    Article  PubMed  Google Scholar 

  194. American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001;108(3):776–89.

    Article  Google Scholar 

  195. World Health Organization. Breastfeeding and maternal medication: recommendations for drugs in the Eleventh WHO Model List of Essential Drugs. Geneva: World Health Organization; 2003. 43 p.

    Google Scholar 

  196. Ito S. Drug therapy for breast-feeding women. NEJM. 2000;343(2):119–26.

    Article  Google Scholar 

  197. Chaudron LH, Jefferson JW. Mood stabilizers during breastfeeding: a review. J Clin Psychiatry. 2000;61(2):79–90.

    Article  CAS  PubMed  Google Scholar 

  198. Nordmo E, Aronsen L, Wasland K, Smabrekka L, Vorren S. Severe apnea in an infant exposed to lamotrigine in breast milk. Ann Pharmacother. 2009;43(11):1983–7.

    Article  Google Scholar 

  199. Uguz F. Second-generation antipsychotics during the lactation period: a comparative systematic review on infant safety. J Clin Psychopharmacol. 2016;36(3):233–52.

    Google Scholar 

  200. Brunner E, Falk DM, Jones M, Dey DK, Shatapathy CC. Olanzapine in pregnancy and breastfeeding: a review of data from global safety surveillance. BMC Pharmacol Toxicol. 2013;14:38.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  201. Winans EA. Antipsychotics and breastfeeding. J Hum Lact. 2001;17(4):344–7.

    Article  CAS  PubMed  Google Scholar 

  202. Gardiner SJ, Kristensen JF, Begg EJ, Hackett LP, Wilson DA, Ilett KF, et al. Transfer of olanzapine into breast milk, calculation of infant drug dose, and effect on breast-fed infants. Am J Psychiatry. 2003;160(8):1428–31.

    Article  PubMed  Google Scholar 

  203. Rampono J, Kristensen JF, Ilett KF, Hackett LP, Kohan R. Quetiapine and breast feeding. Ann Pharmacother. 2007;41(4):711–4.

    Article  CAS  PubMed  Google Scholar 

  204. Lee A, Giesbrecht E, Dunn E, Ito S. Excretion of quetiapine in breast milk. Am J Psychiatry. 2004;161(9):1715–6.

    Article  PubMed  Google Scholar 

  205. Gentile S. Clinical utilization of atypical antipsychotics in pregnancy and lactation. Ann Pharmacother. 2004;38(7–8):1264–71.

    Google Scholar 

  206. Schlotterbeck P, Saur R, Hiemke C, Gründer G, Vehren T, Kircher T, et al. Low concentration of ziprasidone in human milk: a case report. Int J Neuropsychopharmacol. 2009;12(3):437–8. https://doi.org/10.1017/S1461145709009936.. Epub 2009 Feb 10.

    Article  PubMed  Google Scholar 

  207. Leiknes KA, Cooke MJ, Jarosch-von Schweder L, Harboe I, Høie B. Electroconvulsive therapy during pregnancy: a systematic review of case studies. Arch Womens Ment Health. 2015;18(1):1–39.

    Article  PubMed  Google Scholar 

  208. Reed P, Sermin N, Appleby L, Faragher B. A comparison of clinical response to electroconvulsive therapy in puerperal and non-puerperal psychoses. J Affect Disord. 1999;54(3):255–60.

    Article  CAS  PubMed  Google Scholar 

  209. Walker R, Swartz CM. Electroconvulsive therapy during high-risk pregnancy. Gen Hosp Psychiatry. 1994;16(5):348–53.

    Article  CAS  PubMed  Google Scholar 

  210. Anderson EL, Reti IM. ECT in pregnancy: a review of the literature from 1941 to 2007. Psychosom Med. 2009;71(2):235–42.

    Article  PubMed  Google Scholar 

  211. Calaway K, Coshal S, Jones K, Coverdale J, Livingston R. A systematic review of the safety of electroconvulsive therapy use during the first trimester of pregnancy. J ECT. 2016;32(4):230–5.

    Article  PubMed  Google Scholar 

  212. Miller LJ. Use of electroconvulsive therapy during pregnancy. Hosp Community Psychiatry. 1994;45(5):444–50.

    CAS  PubMed  Google Scholar 

  213. Bhatia SC, Baldwin SA, Bhatia SK. Electroconvulsive therapy during the third trimester of pregnancy. J ECT. 1999;15(4):270–4.

    Article  CAS  PubMed  Google Scholar 

  214. Sinha P, Goyal P, Andrade C. A meta-review of the safety of electroconvulsive therapy in pregnancy. J ECT. 2017;33(2):81–8.

    Article  PubMed  Google Scholar 

  215. Saatcioglu O, Tomruk NB. The use of electroconvulsive therapy in pregnancy: a review. Isr J Psychiatry Relat Sci. 2011;48(1):6–11.

    PubMed  Google Scholar 

  216. Deligiannidis KM, Freeman MP. Complementary and alternative medicine therapies for perinatal depression. Best Pract Res Clin Obstet Gynaecol. 2014;28(1):85–95.

    Article  PubMed  Google Scholar 

  217. Manber R, Schnyer RN, Lyell D, Chambers AS, Caughey AB, Druzin M, et al. Acupuncture for depression during pregnancy: a randomized controlled trial. Obstet Gynecol. 2010;115(3):511–20.

    Article  PubMed  Google Scholar 

  218. Schuette SA, Brown KM, Cuthbert DA, Coyle CW, Wisner KL, Hoffman MC, et al. Perspectives from patients and healthcare providers on the practice of maternal placentophagy. J Altern Complement Med. 2017;23(1):60–7.

    Article  PubMed  Google Scholar 

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    Kara Brown

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    Dylan Kathol

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Brown, K., Kathol, D. (2019). Mood Disorders in Pregnancy. In: O’Neal, M. (eds) Neurology and Psychiatry of Women. Springer, Cham. https://doi.org/10.1007/978-3-030-04245-5_18

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