Psychotropic medication during pregnancy and children outcomes: a retrospective case control study

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Introduction: Psychiatric disorders are common in pregnant women. The challenge for doctors lies in treating mental illness, whilst minimizing exposure of the child to medication. Objective: characterize perinatal period, morbidity, psychomotor development and current situation of children whose mothers had been exposed to psychotropic drugs during pregnancy and compare these outcomes with a control group. Method: Retrospective study performed in a maternity hospital of Coimbra, Portugal, during six years. A group of mother-child pairs exposed throughout gestation to psychotropic drugs (psychotropic group) was compared to a healthy group of mother-child pairs not exposed to psychotropic medication throughout pregnancy (no psychotropic group). The two groups were compared in terms of maternal age, neonatal data (gestational age, birth weight, APGAR score), breastfeeding length and screening of psychomotor development of children at 2 years old. The psychotropic group was also characterized in terms of congenital malformations, withdrawal syndrome in the neonatal period and current situation. Results: The sample includes 119 mother-child pairs of the psychotropic group and 100 of the no psychotropic group. Mental disorders of the psychotropic group were divided in three groups: major depression (n=92), bipolar disorder (n=16) or anxiety disorder (n=11). Those women were treated with one or more of the following psychotropic drug: benzodiazepines, selective serotonin reuptake inhibitors, tricyclic antidepressants, neuroleptics or mood stabilizers. Withdrawal syndrome occurred in 0,084% cases and congenital malformations in 1,7% on psychotropic group. Comparing both groups, psychotropic group showed a superior maternal age, more advanced gestational age at delivery and a lower length of breastfeeding. There were no differences regarding the rate of breastfeeding, prematurity, birth weight, APGAR score or psychomotor development. Currently, 87% of the children from psychotropic group live with their mothers. Conclusion: This study suggests lack of adverse outcomes to the children exposed in utero to psychotropic medication. Both groups had similar outcomes. The decision of treating pregnant women with mental disorders should be based on the severity of the disease and ensure the well being of the mother and child.

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