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Psychopharmacology and Pregnancy pp 119–138Cite as

Schizophrenia, Psychopharmacology, and Pregnancy

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Abstract

Most women with schizophrenia have children at some point in their lives despite reduced fertility compared with the general population. They often stop psychotropic medication due to concerns about harming their infant and it is not clear to what extent they are at risk of relapse in pregnancy, though there is good evidence that the postpartum period is a time of increased risk. Their pregnancies are at increased risk of adverse outcomes including pre-eclampsia, poor fetal growth, preterm birth, low birth weight, still births, and neonatal and post-neonatal deaths. Lifestyle risk factors, such as smoking and nutritional deficiencies, are likely to explain many of these outcomes. Current evidence suggests that most antipsychotics are unlikely to be major teratogens, and it is unclear to what extent other adverse outcomes, including developmental outcomes, are related to medication or confounders. Pregnancy in women with a diagnosis of schizophrenia should be considered high risk and managed accordingly. A focus on reducing modifiable risk factors, such as obesity and smoking, ideally before conception, as well as optimising antenatal care using the lowest effective medication doses with appropriate monitoring through pregnancy, is key to improving the long-term outcomes in these vulnerable families.

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Authors and Affiliations

  1. Centre for Women’s Mental Health, The University of Manchester, 3rd Floor East, Jean McFarlane Building, Oxford Rd, Manchester, M13 9PL, UK

    Kathryn M. Abel

  2. South London and Maudsley NHS Foundation Trust, London, UK

    Katie Au

  3. Section of Women’s Mental Health, Institute of Psychiatry, King’s College London, London, SE5 8AF, UK

    Louise M. Howard

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  1. Kathryn M. Abel
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  2. Katie Au
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Correspondence to Louise M. Howard .

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Editors and Affiliations

  1. Perinatal Mental Health, Mercy Hospital for Women, Heidelberg, Australia

    Megan Galbally

  2. Perinatal Mental Health, Mercy Hospital for Women, Heidelberg, Australia

    Martien Snellen

  3. School of Psychology, Deakin University, Victoria, Australia

    Andrew Lewis

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Abel, K.M., Au, K., Howard, L.M. (2014). Schizophrenia, Psychopharmacology, and Pregnancy. In: Galbally, M., Snellen, M., Lewis, A. (eds) Psychopharmacology and Pregnancy. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54562-7_9

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