Citation

Casanova Dias M, Jones I. Medicine (Abingdon) 2020; 48(12): 774-778.

Copyright

(Copyright © 2020, Medicine Publishing)

DOI

10.1016/j.mpmed.2020.09.016

PMID

unavailable

Abstract

Perinatal psychiatric disorders are common and can result in significant suffering for women and their families: suicide is a leading cause of maternal death. The most severe form of postpartum mood disorder - postpartum psychosis - follows approximately 1 in 1000 deliveries. Women who have a history of bipolar disorder or have suffered a previous severe postpartum episode have a many hundred-fold increased risk, and their identification in the antenatal period is a key aspect of management. Decisions regarding the use of psychotropic medication in pregnancy must be made after a full risk-benefit analysis. Risks of taking many medications remain unknown but include teratogenic effects, withdrawal or toxic symptoms in the newborn and long-term developmental effects. However, these must be balanced against the risks of untreated mental illness and the risk of recurrence from stopping or switching well-established and efficacious medications. More data are needed to inform the difficult choices regarding medication that women with severe mental illness have to make in regard to pregnancy. © 2020

Language: en

Keywords

human; mental health; suicide; female; Review; prognosis; bipolar disorder; risk assessment; perinatal; postpartum; maternal death; mental disease; clinical feature; priority journal; nonhuman; puerperal psychosis; high risk patient; teratogenesis; perinatal period; pregnant woman; prenatal period; postnatal depression; postpartum psychosis; puerperal