Interplay between pregnancy and psychiatric disorders

Pregnancy is a physiological period associated with marked biological changes which can affect the psychiatric disorders where, the elevation of certain hormones e.g. estrogen and progesterone affect neurotransmitters e.g. serotonin, dopamine and GABA which are involved in the psychopathology of most psychiatric disorders.There is no agreement about pregnancy that it can improve or worse the psychiatric disorders but pregnancy can improve some psychiatric disorders in certain women but may worse in the others.Risks of untreated active psychiatric disorder in pregnant woman may outweigh the risks of fetal medication exposure in certain cases so careful evaluation of the cases is a must.Family planning should be considered in any woman during the childbearing period especially who developed recent psychiatric illness or on psychiatric medication.General guidelines and nonpharmacological interventions should be considered in mild cases e.g. mild depressive and anxiety disorders. The psychiatrist who deals with pregnant psychiatric women should be aware with recent studies regarding the drug safety and not depends only on the FDA rating.All available decisions about using pharmacological intervention, risks of fetal medication exposure and risks of untreated cases should be clarified to the patient and her family as no decision is risk free.