CRIS Blog: Serious Mental Illness and Pregnancy

Clare Taylor is a Research Worker and PhD student at King’s College London’s department of Health Services & Population Research, and a member of the Psychological Medicine Clinical Academic Group.  She is part of a team researching the risks and benefits of psychotropic drugs in pregnancy through analyses of data from the Case Register Interactive Search (CRIS) system, a unique anonymised mental health care database, developed by the NIHR Maudsley BRC/U.

Serious mental illness includes disorders such as schizophrenia and bipolar disorder, which often require long term treatment with medication.  Most women with these disorders have children, but they often have concerns about the potential effect of medication on the unborn baby, and therefore may stop medication in pregnancy, despite the risk of relapse of mental illness.

The team led by Professor Louise Howard is conducting research using de-identified mental health records from CRIS to understand more about serious mental illness and pregnancy.  Using CRIS and local NHS maternity data we are focusing our study on the de-identified medical data of 456 women on CRIS who were pregnant from 2007-2011. 

High levels of previous experiences of childhood abuse and recent domestic violence are reported in our sample and an increased rate of smoking in pregnancy compared with the general population.  These factors are also sometimes related to poorer pregnancy outcomes, such as low birth weight of infants, but could potentially be addressed with interventions – for example, smoking cessation programs and domestic violence advocacy –which can be tailored to women with serious mental illness. 

We are currently looking at factors that might predict worsening of serious mental illness in pregnancy and after the birth of the baby, including the effects of changing medication.  We have now expanded the cohort to include women pregnant up to March 2013 and with a total of 571 women also plan to investigate health of the mothers who are receiving medication during their pregnancy as well as some measures of health in the newborn baby.  This study is following a much larger number of women than most previous research. It will therefore be able to provide much more evidence than was previously available on the risks and benefits of taking medication for mental disorders during pregnancy.

This work is part funded by the Johnson & Johnson CSR Citizenship Trust and a NIHR Research Professorship. CRIS is supported by the NIHR Maudsley BRC Nucleus at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology and Neuroscience , King’s College London, jointly funded by the South London and Maudsley NHS Foundation Trust (SLaM) and Guy's and St Thomas' Charity.

Tags: CRIS - Informatics - Clinical and population informatics -

By NIHR Maudsley BRC at 1 Mar 2016, 16:16 PM

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