In the developing baby, iodine is necessary for thyroid function and normal brain development. According to a recent Lancet study, even children born to women with mild-to-moderate iodine deficiency during pregnancy are at increased risk for lower IQ and reading ability (assessed at age 9). The most severe effects were observed among children born to women with severe deficiency.
While we have adequate data to support the use of SSRI antidepressants during pregnancy, there is less data regarding other classes of antidepressants. A new case series documents the outcomes of infants exposed to mirtazapine (Remeron).
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.
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:
The following post was first published in OB/GYN News.
This report from the Centers for Disease Control (CDC) was published yesterday and is a good, albeit alarming, companion to the post we published yesterday on obstetrical outcomes.
In a recent study, researchers looked at the rising nationwide trend of opioid abuse and dependence in pregnancy and obstetrical outcomes in this patient population. Previous research has focused on neonatal outcomes, such as neonatal abstinence syndrome; however, maternal complications have not been well-studied. In this study, data was collected from the Nationwide Inpatient Sample (NIS), including nearly 57 million American women who were admitted for obstetric delivery between the years 1998-2011. Overall 113,105 of those women (0.2%) were identified as abusing or being dependent on opioids. The prevalence increased by 127% from the beginning of the study in 1998 until its completion in 2011, reflecting the growing opioid epidemic. The increase was mostly represented in women 20 to 34 years or age.
Last week was National Folic Acid Awareness Week at the Centers for Disease Control (CDC), so this seems like a great time to remind women (and their caregivers) of the importance of folic acid in the prevention of birth defects. By taking the recommended dosage of folic acid daily, women will reduce the risk of neural tube defects by 50% - 70%. In addition, women who take folic acid supplements are less likely to give birth to a child with an autism spectrum disorder.
2014 was a huge year in the field of Reproductive Psychiatry. Never before have we seen so many articles published in this specialty. Much attention has focused on the reproductive safety of psychotropic medication; however, we have seen an increased interest in the mental health of women and a greater appreciation of how psychiatric illness in the mother may affect the entire family, including her unborn child and family.
A recent study examined the prevalence and risk factors for perinatal depression and anxiety in a group of Norwegian women with epilepsy (n = 706) compared to pregnancies in all women without epilepsy (n = 106,511).
