a Monash Alfred Psychiatry Research Centre , Monash University , Melbourne , Australia.
Expert Opin Pharmacother. 2019 Aug;20(11):1365-1376. doi: 10.1080/14656566.2019.1612876. Epub 2019 May 15.
Women with schizophrenia and their babies are at high risk of adverse outcomes in pregnancy and childbirth. A better understanding of the specific risks conferred by the illness itself and by the treatment provided will help guide more effective care of these women.
Herein, the authors review enetic, demographic, socioeconomic, nutritional and lifestyle risks associated with schizophrenia in pregnancy. They also cover specific risks associated with typical antipsychotic medications, specific risks associated with atypical antipsychotic medications, risks associated with polypharmacy and risks of developmental delay in children exposed to antipsychotic medications in utero.
Our understanding of the risks that women with schizophrenia face in pregnancy from their illness and from the treatment they receive continues to evolve. As our ability to analyze data progresses, the risks conferred by antipsychotic medication treatment appear to lessen in clinical and statistical significance, whilst the true risks to these women and their babies from their experience of disadvantage continue to set them aside from the general population. Reducing polypharmacy and providing comprehensive and supportive care can minimize harm to women with schizophrenia and their babies.
患有精神分裂症的女性及其婴儿在妊娠和分娩期间存在不良结局的高风险。更好地了解疾病本身和所提供的治疗带来的具体风险将有助于指导对这些女性进行更有效的护理。
本文作者回顾了与妊娠期间精神分裂症相关的遗传、人口统计学、社会经济、营养和生活方式风险。他们还介绍了与典型抗精神病药物相关的特定风险、与非典型抗精神病药物相关的特定风险、与联合用药相关的风险以及暴露于子宫内抗精神病药物的儿童发育迟缓的风险。
我们对患有精神分裂症的女性在怀孕期间因疾病和治疗而面临的风险的理解仍在不断发展。随着我们分析数据的能力的提高，抗精神病药物治疗带来的风险在临床和统计学意义上似乎有所减轻，而这些女性及其婴儿因处于劣势而面临的真正风险继续使她们与一般人群区分开来。减少联合用药并提供全面和支持性的护理可以最大程度地减少对患有精神分裂症的女性及其婴儿的伤害。
