Maternal, Fetal, and Child Outcomes of Mental Health Treatments in Women: A Meta-Analysis of Pharmacotherapy

Maternal, Fetal, and Child Outcomes of Mental Health Treatments in Women: A Meta-Analysis of Pharmacotherapy

Forfattere
Viswanathan, M. Middleton, J. C. Stuebe, A. M. Berkman, N. D. Goulding, A. N. McLaurin-Jiang, S. Dotson, A. B. Coker-Schwimmer, M. Baker, C. Voisin, C. E. Bann, C. Gaynes, B. N.
Årstall
2021
Tidsskrift
Psychiatric Research and Clinical Practice.
Volum
Sider
Objective: The authors systematically reviewed evidence on pharmacotherapy for perinatal mental health disorders. Method(s): The authors searched for studies of pregnant, postpartum, or reproductive-age women with mental health disorders treated with pharmacotherapy in MEDLINE, EMBASE, PsycINFO, the Cochrane Library, and trial registries from database inception through June 5, 2020 and surveilled literature through March 2, 2021. Outcomes included symptoms; functional capacity; quality of life; suicidal events; death; and maternal, fetal, infant, or child adverse events. Result(s): 164 studies were included. Regarding benefits, brexanolone for third-trimester or postpartum depression onset may be associated with improved depressive symptoms at 30 days when compared with placebo. Sertraline for postpartum depression may be associated with improved response, remission, and depressive symptoms when compared with placebo. Discontinuing mood stabilizers during pregnancy may be associated with increased recurrence of mood episodes for bipolar disorder. Regarding adverse events, most studies were observational and unable to fully account for confounding. Evidence on congenital and cardiac anomalies for treatment compared with no treatment was inconclusive. Brexanolone for depression onset in the third trimester or the postpartum period may be associated with risk of sedation or somnolence, leading to dose interruption or reduction when compared with placebo. Conclusion(s): Evidence from few studies supports the use of pharmacotherapy for perinatal mental health disorders. Although many studies report on adverse events, they could not rule out underlying disease severity as the cause of the association between exposures and adverse events. Patients and clinicians need to make informed, collaborative decisions on treatment choices. Copyright © 2021 The Authors. Psychiatric Research and Clinical Practice published by Wiley Periodicals LLC. on behalf of the American Psychiatric Association

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Tiltaksnivå

Behandling og hjelpetiltak

Tema

Psykiske vansker og lidelser

Følelsesmessige problemer

Bipolare lidelser

Angstproblematikk

Angst og engstelighet (inkl. både vansker og lidelse)

ADHD

Autismespekter

Andre problemer

Psykose

Foreldreferdigheter

Tilknytning

Fødsels-/barselsdepresjon

Utvikling og livsmestring

Kognisjon (hukommelse, oppmerksomhet, eksekutive funksjoner)

Sosiale ferdigheter (inkl. vennerelasjoner)

Biologiske risikofaktorer, sykdommer og symptomer

Bivirkninger/uønskede effekter

Gravide (inkl. tenåringsmødre)

Tiltak

Medikamentell behandling

Antidepressiva

Antipsykotisk medisin

20.60 Epilepsimedisin

Aldersgruppe

Uklar aldersgruppe

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