Approximately 66.6% of women with a history of mental illness give birth. However, treatment guidelines are "largely speculative" and there has been little research into the safety and effectiveness of giving these women psychiatric medications during pregnancy, even though significant morbidity has been associated with maternal mental illness during pregnancy.
Katrina C. Johnson, Ph.D., and colleagues from Emory University, Atlanta, analyzed the association of prenatal exposure to antipsychotics, antidepressants and maternal psychiatric illness in 309 six-month-old infants with adverse neuromotor and attentional outcomes. 22 of the infants' mothers took antipsychotics during pregnancy, 202 took antidepressants, and 85 took no psychiatric medications during pregnancy.
The neuromotor exam administered was the Infant Neurological International Battery (INFANIB), which tests motor skills, posture, reflexes, and tone. In addition, the researchers examined the infants' visual response intensity to stimuli.
The researchers explained:
"The results from the current study show that 6-month-old infants exposed prenatally to an antipsychotic demonstrated significantly lower scores on standardized neuromotor screening measure compared with both antidepressant-exposed infants and infants with no psychotropic exposure.
Only 19 percent of infants prenatally exposed to an antipsychotic demonstrated normal neuromotor performance."
In addition, the team highlight that infant outcomes were not associated with indices of maternal psychiatric illness.
"Future investigations are warranted to disentangle the relative contribution of antipsychotic medications, maternal mental illness, concomitant (associated) medications and the broader psychosocial context in the developmental trajectory of high-risk infants.
Pending such studies, these data support an additional level of clinical scrutiny in medication selection, treatment planning and risk/benefit discussions for women with illnesses who may warrant antipsychotic pharmacotherapy during gestation."