Objective Perinatal mental illness presents challenges to obstetricians. Mental illness of all severities can have in impact on maternal and infant outcomes. There is an increasing evidence for the use of anti-depressants in pregnancy, but a paucity of data for women using anti-psychotics.
Design A retrospective casenote review of all cases attending an antenatal mental health clinic between April 2011–12.
Setting Background fetal growth restriction rate 13%
Results 282 women were referred to the clinic. 215 had depressive disorders, with 139 (76.2%) on psychotropic medication. 132 (87.4%) of the women were on antidepressants and 18 (12%) on anti-psychotics. 28 (20%) babies were below the 10th customised centile & 19 (13%) were diagnosed with a congenital abnormality at birth. 72 had anxiety disorders with 32 (63%) on antidepressants and, 10 (20%) on atypical anti-psychotics, 5 (10%) had babies diagnosed with anomalies at delivery. 14 (29%) babies in this group were below the 10th. 5 women with psychotic disorders were all on antidepressants and anti-psychotics. 2 (40%) of the babies were below the 10th centile. Ten women had bipolar disease and 6 used anti-psychotics. One (16%) baby was below the 10th percentile.
In total 12 women took olanzepine and of these 8 (66%) babies had a congenital anomaly, 4 had tongue tie but 3 babies (on fluoxetine and olanzepine) had major congenital heart disease.
Conclusion Women referred to a mental health clinic had increased rates of growth restriction compared with the general population. Numbers are small but association of antenatal anti-psychotics with fetal growth restriction and congenital anomalies needs to be considered.
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