Epidemiology and Psychiatric Sciences

Original Articles

Use of antipsychotic drugs and mood stabilizers in women of childbearing age with schizophrenia and bipolar disorder: epidemiological survey

C. Barbuia1 c1, V. Contia2, M. Purgatoa1, A. Cipriania1, I. Fortinoa3, A. L. Rivoltaa2 and A. Loraa4

a1 Section of Psychiatry, Department of Public Health and Community Medicine, University of Verona, Verona, Italy

a2 Regional Centre for Pharmacovigilance, Lombardy Region, Milano, Italy

a3 Operative Unit of Territorial Health Services, Lombardy Region, Milano, Italy

a4 Department of Psychiatry, Azienda Ospedaliera Della Provincia di Lecco, Lecco, Italy

Abstract

Aims. To determine the prevalence of women of childbearing age with schizophrenia and bipolar disorder exposed to antipsychotic (AP) drugs and mood stabilizers (MS) in Lombardy, a European region of 10 million inhabitants and 1 752 285 women of childbearing age.

Methods. The data concerning psychiatric care, drug treatments and pregnancy outcomes were retrieved from local administrative databases during a 12-month census period.

Results. During a 12-month census period, 2893 women of childbearing age with schizophrenia (74.8% of all women of childbearing age with schizophrenia) and 918 with bipolar disorder (80.1% of all women of childbearing age with bipolar disorder) were exposed to AP drugs or MS, yielding a prevalence of exposure for women with schizophrenia of 1.65 (95% confidence interval (CI) 1.59–1.71) per 1000 female inhabitants, and for women with bipolar disorder of 0.52 (95% CI 0.49–0.55) per 1000 female inhabitants. Persistent exposure to potentially teratogenic medications accounted for one in every 1000 women of childbearing age. Of the 57 pregnancies in women with schizophrenia, normal delivery was recorded in 23 (40%) cases; of the 26 pregnancies in women with bipolar disorder, normal delivery was recorded in 10 (38%) cases.

Conclusions. In women of childbearing age with severe mental disorders, exposure to psychotropic drugs is substantial, which suggests that the issue of reproductive health is epidemiologically relevant and a major public health concern.

(Received October 26 2012)

(Revised December 14 2012)

(Accepted December 26 2012)

(Online publication February 01 2013)

Key words

  • bipolar disorder;
  • childbearing age;
  • psychotropic drugs;
  • schizophrenia

Correspondence

c1 Address for correspondence: Professor C. Barbui, Section of Psychiatry, Department of Public Health and Community Medicine, University of Verona, Policlinico GB Rossi, Piazzale Scuro 10, 37134 Verona, Italy. (Email: corrado.barbui@univr.it)