The effects of gestational use of antidepressants and antipsychotics on neonatal outcomes for women with severe mental illness

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    Abstract

    Background: Psychotropic medication use occurs in 8% of pregnancies, with rates increasing, and often multiple medications prescribed. Aims: This study aims to determine if the use of psychotropic medication, in a cohort of women with severe mental illness, increases rates of special care nursery admission and reports differences between antidepressant and antipsychotic medication use either alone or in combination. Methods: A retrospective database analysis from a cohort with severe mental illness in pregnancy identified 268 pregnant women who were grouped according to medication type. Demographic, obstetric and neonatal variables were analysed using t-tests, χ2, analysis of variance and logistic regression analysis for special care nursery admission. Results: The medication groups consisted of: women taking no psychotropic medications (n = 67); those taking antipsychotics (n = 87); those taking antidepressants (n = 55); those taking and a combination of antidepressants/antipsychotics (n = 59). Rates of special care nursery admission in women who took psychotropic medication (41.3%) were elevated compared to those who did not (26.9%) (P = 0.035), and were significantly raised when compared to the general population (P < 0.000). No significant difference occurred between the medication groups. A significant adjusted odds ratio of 2.79 (95% CI 1.286–6.049) was found for special care nursery and psychiatric admission during pregnancy but not for psychotropic medication. Conclusion: Rates of special care nursery admission are elevated in neonates of women with severe mental illness taking psychotropic medication, but were not different for monotherapy or polytherapy when prescribing antidepressants or antipsychotic medication. Additional vulnerability occurs in the neonates of women with a mental illness and paediatric presence at delivery is recommended.
    Original languageEnglish
    Pages (from-to)526-532
    JournalAustralian and New Zealand Journal of Obstetrics and Gynaecology
    Volume57
    Issue number5
    DOIs
    Publication statusPublished - 2017

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    Nurseries
    Antidepressive Agents
    Antipsychotic Agents
    Pregnancy
    Newborn Infant
    Obstetrics
    Psychiatry
    Pregnant Women
    Analysis of Variance
    Cohort Studies
    Logistic Models
    Odds Ratio
    Regression Analysis
    Demography
    Databases
    Pediatrics
    Population

    Cite this

    @article{47f3032adca94b2aa5eb32a4211af738,
    title = "The effects of gestational use of antidepressants and antipsychotics on neonatal outcomes for women with severe mental illness",
    abstract = "Background: Psychotropic medication use occurs in 8{\%} of pregnancies, with rates increasing, and often multiple medications prescribed. Aims: This study aims to determine if the use of psychotropic medication, in a cohort of women with severe mental illness, increases rates of special care nursery admission and reports differences between antidepressant and antipsychotic medication use either alone or in combination. Methods: A retrospective database analysis from a cohort with severe mental illness in pregnancy identified 268 pregnant women who were grouped according to medication type. Demographic, obstetric and neonatal variables were analysed using t-tests, χ2, analysis of variance and logistic regression analysis for special care nursery admission. Results: The medication groups consisted of: women taking no psychotropic medications (n = 67); those taking antipsychotics (n = 87); those taking antidepressants (n = 55); those taking and a combination of antidepressants/antipsychotics (n = 59). Rates of special care nursery admission in women who took psychotropic medication (41.3{\%}) were elevated compared to those who did not (26.9{\%}) (P = 0.035), and were significantly raised when compared to the general population (P < 0.000). No significant difference occurred between the medication groups. A significant adjusted odds ratio of 2.79 (95{\%} CI 1.286–6.049) was found for special care nursery and psychiatric admission during pregnancy but not for psychotropic medication. Conclusion: Rates of special care nursery admission are elevated in neonates of women with severe mental illness taking psychotropic medication, but were not different for monotherapy or polytherapy when prescribing antidepressants or antipsychotic medication. Additional vulnerability occurs in the neonates of women with a mental illness and paediatric presence at delivery is recommended.",
    author = "Jacqueline Frayne and Thinh Nguyen and Kellie Bennett and S. Allen and Y. Hauck and Helena Liira",
    year = "2017",
    doi = "10.1111/ajo.12621",
    language = "English",
    volume = "57",
    pages = "526--532",
    journal = "The Australian and New Zealand Journal of Obstetrics and Gynaecology",
    issn = "0004-8666",
    publisher = "John Wiley & Sons, Ltd (10.1111)",
    number = "5",

    }

    TY - JOUR

    T1 - The effects of gestational use of antidepressants and antipsychotics on neonatal outcomes for women with severe mental illness

    AU - Frayne, Jacqueline

    AU - Nguyen, Thinh

    AU - Bennett, Kellie

    AU - Allen, S.

    AU - Hauck, Y.

    AU - Liira, Helena

    PY - 2017

    Y1 - 2017

    N2 - Background: Psychotropic medication use occurs in 8% of pregnancies, with rates increasing, and often multiple medications prescribed. Aims: This study aims to determine if the use of psychotropic medication, in a cohort of women with severe mental illness, increases rates of special care nursery admission and reports differences between antidepressant and antipsychotic medication use either alone or in combination. Methods: A retrospective database analysis from a cohort with severe mental illness in pregnancy identified 268 pregnant women who were grouped according to medication type. Demographic, obstetric and neonatal variables were analysed using t-tests, χ2, analysis of variance and logistic regression analysis for special care nursery admission. Results: The medication groups consisted of: women taking no psychotropic medications (n = 67); those taking antipsychotics (n = 87); those taking antidepressants (n = 55); those taking and a combination of antidepressants/antipsychotics (n = 59). Rates of special care nursery admission in women who took psychotropic medication (41.3%) were elevated compared to those who did not (26.9%) (P = 0.035), and were significantly raised when compared to the general population (P < 0.000). No significant difference occurred between the medication groups. A significant adjusted odds ratio of 2.79 (95% CI 1.286–6.049) was found for special care nursery and psychiatric admission during pregnancy but not for psychotropic medication. Conclusion: Rates of special care nursery admission are elevated in neonates of women with severe mental illness taking psychotropic medication, but were not different for monotherapy or polytherapy when prescribing antidepressants or antipsychotic medication. Additional vulnerability occurs in the neonates of women with a mental illness and paediatric presence at delivery is recommended.

    AB - Background: Psychotropic medication use occurs in 8% of pregnancies, with rates increasing, and often multiple medications prescribed. Aims: This study aims to determine if the use of psychotropic medication, in a cohort of women with severe mental illness, increases rates of special care nursery admission and reports differences between antidepressant and antipsychotic medication use either alone or in combination. Methods: A retrospective database analysis from a cohort with severe mental illness in pregnancy identified 268 pregnant women who were grouped according to medication type. Demographic, obstetric and neonatal variables were analysed using t-tests, χ2, analysis of variance and logistic regression analysis for special care nursery admission. Results: The medication groups consisted of: women taking no psychotropic medications (n = 67); those taking antipsychotics (n = 87); those taking antidepressants (n = 55); those taking and a combination of antidepressants/antipsychotics (n = 59). Rates of special care nursery admission in women who took psychotropic medication (41.3%) were elevated compared to those who did not (26.9%) (P = 0.035), and were significantly raised when compared to the general population (P < 0.000). No significant difference occurred between the medication groups. A significant adjusted odds ratio of 2.79 (95% CI 1.286–6.049) was found for special care nursery and psychiatric admission during pregnancy but not for psychotropic medication. Conclusion: Rates of special care nursery admission are elevated in neonates of women with severe mental illness taking psychotropic medication, but were not different for monotherapy or polytherapy when prescribing antidepressants or antipsychotic medication. Additional vulnerability occurs in the neonates of women with a mental illness and paediatric presence at delivery is recommended.

    U2 - 10.1111/ajo.12621

    DO - 10.1111/ajo.12621

    M3 - Article

    VL - 57

    SP - 526

    EP - 532

    JO - The Australian and New Zealand Journal of Obstetrics and Gynaecology

    JF - The Australian and New Zealand Journal of Obstetrics and Gynaecology

    SN - 0004-8666

    IS - 5

    ER -