Peripartum psychiatric disorders

Women are at greatest risk of suffering from mental illness during their reproductive years, and at very particular risk in relation to childbirth. Psychological adjustment, social challenges, and neurohormonal changes in pregnancy and parturition may all contribute to this risk. The consequences of maternal mental illness may be severe. Suicide is among the leading causes of maternal death in the United Kingdom and psychiatric factors are implicated in a further significant number of deaths in pregnancy and the first postnatal year. Increasing evidence points to the detrimental effect of untreated maternal anxiety and depression on infant development. Women may be taking psychotropic medication at conception, with antidepressants being one of the most frequently prescribed. Certain psychotropics have important adverse effects on the fetus and developing child, and may require careful management if prescribed in pregnancy. All professionals involved in the care of women at this time have an important role in identifying those at risk, reducing progression to future morbidity and mortality, and minimizing the adverse effects of prescribed medication.