School of Medicine, The University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia.
Peel and Rockingham Kwinana Mental Health Service, Rockingham, WA, 6168, Australia.
Arch Womens Ment Health. 2020 Jun;23(3):441-445. doi: 10.1007/s00737-019-00985-1. Epub 2019 Jun 15.
Clozapine is an effective antipsychotic that can lead to symptom resolution and functional recovery in patients with schizophrenia. Its available pregnancy safety data remain limited, which presents a challenge for clinicians managing women of reproductive age on clozapine. We retrospectively studied a consecutive case series of nine pregnancies where there was clozapine exposure. Our case series demonstrates that pregnant women on clozapine treatment can remain stable psychiatrically, but are vulnerable obstetrically, with high rates of obesity and gestational diabetes. Their babies also have poor neonatal adjustment, often requiring neonatal resuscitation. Furthermore, we report on clozapine-related side effects, changes in clozapine levels during pregnancy as well as variation in foetal wellbeing monitoring. These findings have implications for pregnancy care for women taking clozapine and require further exploration.
氯氮平是一种有效的抗精神病药物，可导致精神分裂症患者症状缓解和功能恢复。其现有的妊娠安全性数据仍然有限，这给管理育龄期氯氮平女性患者的临床医生带来了挑战。我们回顾性研究了连续的 9 例妊娠期氯氮平暴露的病例系列。我们的病例系列表明，服用氯氮平治疗的孕妇在精神上可以保持稳定，但在产科方面很脆弱，肥胖和妊娠期糖尿病的发生率很高。她们的婴儿也新生儿适应不良，经常需要新生儿复苏。此外，我们还报告了氯氮平相关的副作用、妊娠期间氯氮平水平的变化以及胎儿健康监测的差异。这些发现对服用氯氮平的女性的妊娠护理有影响，需要进一步探讨。
