Is it safe to use antipsychotics during pregnancy?

We don’t know enough about the risks and benefits of the drugs used to treat severe mental illness during pregnancy. Tommy’s is trying to change this.

Women with severe mental illness such as schizophrenia or bipolar disorder are more likely to give birth too early, to babies with a low birth weight. They are also more at risk of stillbirth.

At the moment, there simply isn’t enough knowledge about why. We don’t know if these women suffer because of the medications that help control their illnesses – including the effects of changing or stopping treatment. We don’t know if instead it might be because of the stress of being ill, or other factors like smoking or obesity.

Tommy’s want to find out about the risks and benefits of using psychotropic medication – drugs that affect a person’s mind or behaviour – to treat mental illness during pregnancy.

To do this, we are using information to our advantage. We are using a tool called the Case Register Interactive Search system (CRIS) that will let us find full, anonymised medical records linked to maternity information. We will look at the records of patients who have been cared for by the South London Maudsley NHS foundation Trust (SLAM). This will help us to find out how mental illness was treated during pregnancy, and if treatment was related to any complications.

So far, we have information from over 450 women about which drugs they used during pregnancy. We have also looked at self-harm during pregnancy, along with women who were admitted to acute psychiatric services – this includes being taken to hospital or being helped at home. We hope that by looking at this information, we’ll be able to find ways of telling when an expecting mother with mental illness is likely to self-harm. We also want to find out why women whose illnesses have been stable before pregnancy might relapse while pregnant.  

Some of our work has already been published in BMC Psychiatry and the Archives of Women's Mental Health. However, we are carrying on looking at more information, trying to find the missing links between mental illness, treatment, and pregnancy complications. Analysis of current information should be finished by the end of the year. At the same time, we are also starting new projects looking at the health of newborn babies born to mothers with mental illness.  

Researchers

Professor Louise Howard, Clare Taylor, Professor Lucilla Poston

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Funding

This study takes place in a Tommy's centre and is funded by Tommy's, the King's College London Institute of Psychiatry, Psychology and Neuroscience, and the National Institute for Health Research

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