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Effects of prenatal antipsychotic exposure on infants

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In an effort to examine the effects of intrauterine antipsychotic medication exposure, Emory researchers conducted a preliminary study examining the neuromotor performance of six-month-old infants whose mothers suffer from psychiatric illness. The findings show lower scores on a screening measure of neuromotor performance. Results of the study are reported online in the Archives of General Psychiatry.

"Clinicians and patients are regularly confronted with the arduous task of balancing the risks and benefits of psychiatric treatment during pregnancy," says Katrina C. Johnson, PhD, lead author for the study and Senior Research Associate in the Department of Psychiatry and Behavioral Sciences at Emory.

"Although about two-thirds of women with a history of mental illness give birth, there have been little data assessing the safety of prenatal psychotropic therapy, particularly assessing an infant’s development following delivery."

The study was conducted from December 1999 through June 2008.  Researchers examined 309 mother-infant pairs at six months postpartum: 22 were exposed to antipsychotics, 202 were exposed to antidepressants, 85 were not exposed to any psychiatric medications.  The Infant Neurological International Battery (INFANIB) exam was administered to assess posture, tone, reflexes and motor skills. The infants’ visual response to stimuli also was examined.

Infants prenatally exposed to antipsychotics showed significantly lower INFANIB scores than infants prenatally exposed to antidepressants or those with no medication exposure. The INFANIB scores were also significantly associated with maternal psychiatric illness.

Taken together, results from the current study raise concerns about the potential neurodevelopmental impact of fetal exposure to both antipsychotic medication and maternal psychiatric illness.

"Given the preliminary nature of these data, using these findings to govern clinical decision-making would be premature," say the researchers. "However, the study strongly underscores the critical need to conduct more research to improve our understanding of the neurodevelopmental consequences of both prenatal exposure to psychiatric medications and maternal mental illness."

A follow-up study is currently under way at Emory.

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