Antipsychotic medication taken during pregnancy can affect babies, study claims

Taking antipsychotic medication during pregnancy can increase the chances of babies being born prematurely or needing special care, according to an Australian study.

The study, published in the journal PLOS ONE, found that while most women gave birth to healthy babies, the use of mood stabilisers or higher doses of antipsychotics during pregnancy increased the need for special care after birth with 43% of babies placed in a Special Care Nursery or a Neonatal Intensive Care Unit, almost three times the national rate in Australia.

As well as an increased likelihood of the need for intensive care, the study by experts from the Monash Alfred Psychiatry Research Centre (MAPrc) and Monash University, shows antipsychotic drugs affects babies in other ways; 18% were born prematurely, 37% showed signs of respiratory distress and 15% developed withdrawal symptoms.

With no existing data to draw on, MAPrc established the National Register of Antipsychotic Medications in Pregnancy in 2005. Women who were pregnant and taking antipsychotic medication were recruited from around Australia through clinical networks in each state and territory. In all 147 women were interviewed every 6 weeks during pregnancy and then followed until their babies were one year old.

Principal investigator, Professor Jayashri Kulkarni, director of MAPrc, said the study highlights the need for clearer health guidelines when antipsychotic drugs are taken during pregnancy. “There’s been little research on antipsychotic medication during pregnancy and if it affects babies. The lack of data has made it very difficult for clinicians to say anything conclusively on how safe it is for babies.

“This new research confirms that most babies are born healthy, but many experience neonatal problems such as respiratory distress."

Professor Kulkarni added the emergence of new antipsychotic drugs means that many women with a well-controlled psychiatric disorder are able to contemplate having babies, but there have always been concerns about the effect of treatment on their offspring.

“The potentially harmful effects of taking an antipsychotic drug in pregnancy have to be balanced against the harm of untreated psychotic illness. The good news is we now know there are no clear associations with specific congenital abnormalities and these drugs.

“However clinicians should be particularly mindful of neonatal problems such as respiratory distress, so it’s critical that Neonatal Intensive Care Units, or Special Care Nurseries are available for these babies."