{"title":"围产期精神病学","authors":"Marisa Casanova Dias, Ian Jones","doi":"10.1016/j.mpmed.2024.06.007","DOIUrl":null,"url":null,"abstract":"<div><p>Perinatal psychiatric disorders are common and can result in significant suffering for women and their families: suicide is a leading cause of maternal death. The most severe form of postpartum mood disorder – postpartum psychosis – follows approximately 1 in 1000 deliveries. Women who have a history of bipolar disorder or who have suffered a previous severe postpartum episode have a many-hundred-fold increased risk, and identifying them in the antenatal period is a key aspect of management. Decisions regarding the use of psychotropic medication in pregnancy must be made after a full risk–benefit analysis. The risks of taking many medications remain unknown but include teratogenic effects, withdrawal or toxic symptoms in the newborn and long-term developmental effects. However, these must be balanced against the risks of untreated mental illness and the risk of recurrence from stopping or switching well-established and efficacious medications. More data are needed to inform the difficult choices regarding medication that women with severe mental illness have to make in regard to pregnancy.</p></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"52 9","pages":"Pages 547-551"},"PeriodicalIF":0.0000,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Perinatal psychiatry\",\"authors\":\"Marisa Casanova Dias, Ian Jones\",\"doi\":\"10.1016/j.mpmed.2024.06.007\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>Perinatal psychiatric disorders are common and can result in significant suffering for women and their families: suicide is a leading cause of maternal death. The most severe form of postpartum mood disorder – postpartum psychosis – follows approximately 1 in 1000 deliveries. Women who have a history of bipolar disorder or who have suffered a previous severe postpartum episode have a many-hundred-fold increased risk, and identifying them in the antenatal period is a key aspect of management. Decisions regarding the use of psychotropic medication in pregnancy must be made after a full risk–benefit analysis. The risks of taking many medications remain unknown but include teratogenic effects, withdrawal or toxic symptoms in the newborn and long-term developmental effects. However, these must be balanced against the risks of untreated mental illness and the risk of recurrence from stopping or switching well-established and efficacious medications. More data are needed to inform the difficult choices regarding medication that women with severe mental illness have to make in regard to pregnancy.</p></div>\",\"PeriodicalId\":74157,\"journal\":{\"name\":\"Medicine (Abingdon, England : UK ed.)\",\"volume\":\"52 9\",\"pages\":\"Pages 547-551\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-07-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Medicine (Abingdon, England : UK ed.)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1357303924001506\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medicine (Abingdon, England : UK ed.)","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1357303924001506","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Perinatal psychiatric disorders are common and can result in significant suffering for women and their families: suicide is a leading cause of maternal death. The most severe form of postpartum mood disorder – postpartum psychosis – follows approximately 1 in 1000 deliveries. Women who have a history of bipolar disorder or who have suffered a previous severe postpartum episode have a many-hundred-fold increased risk, and identifying them in the antenatal period is a key aspect of management. Decisions regarding the use of psychotropic medication in pregnancy must be made after a full risk–benefit analysis. The risks of taking many medications remain unknown but include teratogenic effects, withdrawal or toxic symptoms in the newborn and long-term developmental effects. However, these must be balanced against the risks of untreated mental illness and the risk of recurrence from stopping or switching well-established and efficacious medications. More data are needed to inform the difficult choices regarding medication that women with severe mental illness have to make in regard to pregnancy.