Antipsychotic Use in Pregnancy: Patient Mental Health Challenges, Teratogenicity, Pregnancy Complications, and Postnatal Risks

Authors

Amber N. Edinoff, Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Science Center Shreveport, Shreveport, LA 71103, USA.
Niroshan Sathivadivel, Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Science Center Shreveport, Shreveport, LA 71103, USA.
Shawn E. McNeil, Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Science Center Shreveport, Shreveport, LA 71103, USA.
Austin I. Ly, College of Medicine, The University of Tennessee Health Science Center, Memphis, TN 38103, USA.
Jaeyeon Kweon, School of Medicine, Louisiana State University Health New Orleans, New Orleans, LA 70112, USA.
Neil Kelkar, College of Medicine-Phoenix, University of Arizona, Phoenix, AZ 85004, USA.
Elyse M. Cornett, Department of Anesthesiology, Louisiana State University Health Science Center Shreveport, Shreveport, LA 71103, USA.
Adam M. Kaye, Department of Pharmacy Practice, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Stockton, CA 95211, USA.
Alan D. Kaye, Department of Anesthesiology, Louisiana State University Health Science Center Shreveport, Shreveport, LA 71103, USA.

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.

Publication Title

Neurology international

Recommended Citation

Edinoff, Amber N.; Sathivadivel, Niroshan; McNeil, Shawn E.; Ly, Austin I.; Kweon, Jaeyeon; Kelkar, Neil; Cornett, Elyse M.; Kaye, Adam M.; and Kaye, Alan D., "Antipsychotic Use in Pregnancy: Patient Mental Health Challenges, Teratogenicity, Pregnancy Complications, and Postnatal Risks" (2022). Loewenberg College of Nursing Faculty Publications. 12.
https://digitalcommons.memphis.edu/lcon-facpubs/12