Topiramate (Topamax) in Pregnancy May Affect Fetal Growth
This is a paper I missed from 2014, but I think this study adds some important information to the review we posted on topiramate a few weeks ago.
You Asked: Is Smoking While Breastfeeding Safe?
This is one of the most common questions sent in to our website. Many women ask if it is safe to smoke while they are breastfeeding. Smoking is relatively common during pregnancy, with about 10% of all women smoking at some point during their pregnancy. The rates are even higher among women with psychiatric illness. While many women may be able to stop smoking or reduce their intake during pregnancy, most women resume smoking during the postpartum period.  And women who suffer from postpartum depression are at even higher risk for smoking relapse.
Psychological Distress in the Mother May Affect Levels of Immunoglobulins in Breast Milk
We have seen multiple studies which indicate that postpartum depression (PPD) interferes with breastfeeding. Postpartum women who suffer from depression are less likely to breastfeed, and they typically breastfeed for a shorter duration than women who are not depressed. A recent study looks at an entirely different question, asking whether postpartum stress affects the quality of the breast milk. In this study, the researchers focused on levels of immunoglobulin A (IgA) in the breast milk. (Immunoglobulins or antibodies are passed from the mother to the baby through the breast milk and help to confer immunity.)
Clinical Update: Use of Topiramate (Topamax) During Pregnancy
Topiramate (TPM, marketed as Topamax) is an antiepileptic drug which is also used for migraine prophylaxis, weight loss, and, less commonly, as a mood stabilizer. Over the last few years we have seen several studies suggesting an increased risk of oral clefts in infants exposed to topiramate during the first trimester of pregnancy. You can read more about those studies here:
Avoid Valproic Acid in Women of Reproductive Age
The European Medicine Agency (EMA)'s Pharmacovigilance and Risk Assessment Committee recently recommended strengthening the restrictions on the use of valproic acid in women of reproductive age. Over the last few years, we have seen a host of articles documenting the deleterious effects of valproic acid on the developing fetus:
PTSD in Veterans Increases Risk of Preterm Birth
Posttraumatic stress disorder (PTSD) is relatively common among pregnant and postpartum women. The lifetime prevalence of PTSD for women is about 10%. PTSD is most prevalent among women of childbearing age and PTSD symptoms are common during pregnancy. Earlier this year, we reported on a study which observed that women with a diagnosis of PTSD had an increased risk of preterm birth. The risk was particularly high in those women with diagnoses of both PTSD and a major depressive episode; these women had a 4-fold increased risk of preterm birth.
Postpartum Depression and Positive Parenting Practices
How does postpartum depression affect a mother’s ability to care for and parent her child? Various studies have demonstrated that depressed mothers may be less attuned to their children’s needs, either being less responsive to the baby or, in some cases, too intrusive. Researchers have speculated that this mismatch between mother and baby may contribute to problems with infant bonding, delays in development and emotional dysregulation.
SSRI Exposure during Pregnancy: What’s Enough Data?
The following post was first published in OB/GYN News.
Anti-Epileptic Drugs and Risk of Miscarriage
Do anti-epileptic drugs increase the risk for miscarriage and/or stillbirth? Many reports have demonstrated an association between the use of antiepileptic drugs during pregnancy and increased risk of congenital malformations and pregnancy complications, including pre-eclampsia, [...]
Prenatal Valproate Exposure and Risk of Autism Spectrum Disorders
Autism spectrum disorders (ASDs), which include childhood autism, autistic disorder, Asperger syndrome, atypical autism, and other pervasive developmental disorders, are characterized by social and communication difficulties and by stereotyped or repetitive behaviors and interests. It [...]