Pregnancy Risks for Those with Schizophrenia and Intellectual Disabilities

Q: Pregnancy Risks for Those with Schizophrenia and Intellectual Disabilities

Hello： 1. <br>During the use of psychiatric medications, it is essential to discuss with your physician any potential adjustments to your medication if you are planning to become pregnant, as these medications may affect the fetus. <br>2. <br>The causes of preterm birth are compl

Affective Disorder

I have been diagnosed with mild schizophrenia.
I have been taking psychiatric medications since I was in the first year of junior high school, and I am currently on the following medications: Depakote 500 mg extended-release, Seroquel 200 mg extended-release, Seroquel 50 mg immediate-release, Mirtazapine, and Melatonin, all taken before bedtime.
I regularly attend follow-up appointments at the Child Psychiatry Department of National Taiwan University Hospital.
I am currently 17 years old and a senior in the Comprehensive Vocational Program at Taishan High School.
In the past, during my first and second years of high school, I engaged in self-harm, but I am currently experiencing some recurring depression.

I would like to ask if, because I was a low-birth-weight premature infant (born at only 800 grams), and I have been on medication since my teenage years, can I still get pregnant and have children? Will my children also be premature? Additionally, both my boyfriend and I have mild intellectual disabilities, and we are in a romantic relationship.
Will our children also have intellectual disabilities? What is the genetic probability of having children with intellectual disabilities given our conditions of schizophrenia and intellectual disability?
My boyfriend has plans for the future, such as teaching our child how to take the train at a young age and aspiring to become a successful YouTuber with a train-themed channel.
He also mentioned that if we have a son, he would teach him video games and drumming, while if we have a daughter, I would take on that responsibility.
However, I am really worried that these medications might have toxic effects that could negatively impact the development of any future fetus, both physically and mentally.
Thank you, doctor, for being willing to answer my questions.
My doctor has mentioned that I will need to take medication for life.
I have experienced episodes in the past, with the most recent one occurring in December of last year when I had increased paranoid delusions.
My symptoms of schizophrenia include hearing voices, having strange thoughts, and sometimes seeing certain things.

Lian Xiumin, 10~19 year old female. Ask Date: 2021/01/16

Dr. Cai Qijin reply Psychiatry

Hello: 1.
During the use of psychiatric medications, it is essential to discuss with your physician any potential adjustments to your medication if you are planning to become pregnant, as these medications may affect the fetus.
2.
The causes of preterm birth are complex; please consult an obstetrician-gynecologist.
3.
Schizophrenia and intellectual disabilities have genetic factors; if one parent or sibling has schizophrenia, the risk of developing the disorder is approximately 10%.
4.
Marriage and child-rearing involve many considerations, such as finances, employment, and the maturity of both partners.
Since you are still young, it is advisable to discuss these matters with both families and your physician, and to prepare thoroughly before making a decision.

Reply Date: 2021/01/16

More Info

When considering pregnancy risks for individuals with schizophrenia and intellectual disabilities, several important factors must be taken into account. Your situation is complex, given your history of mental health issues, the medications you are taking, and your concerns about potential genetic implications for your future children.

First and foremost, it is crucial to discuss your desire to become pregnant with your healthcare provider. The medications you are currently taking, including long-acting and short-acting antipsychotics, as well as other psychiatric medications, can have varying effects on pregnancy and fetal development. Some medications may pose risks, while others may be safer. For example, certain antipsychotics are classified as Category C, meaning that risk cannot be ruled out, and they should only be used if the potential benefits justify the potential risks to the fetus. Your doctor may consider adjusting your medication regimen to minimize risks while ensuring your mental health remains stable.

Regarding your concerns about being a low-birth-weight premature infant and the potential for your child to also be born prematurely, it is important to note that while some factors contributing to premature birth can be genetic, many are environmental or related to maternal health. Your history as a premature infant does not guarantee that your child will experience the same issues, but it does warrant careful monitoring during pregnancy. Regular prenatal care is essential to manage any risks effectively.

As for the potential for your children to inherit intellectual disabilities or schizophrenia, research indicates that there is a genetic component to these conditions. If both parents have a history of intellectual disabilities, the likelihood of their children having similar challenges may be higher. The exact risk can vary widely based on numerous factors, including the specific nature of the disabilities and family history. Generally, the risk of developing schizophrenia is estimated to be around 10% if one parent is affected, but this can be influenced by many variables.

It is also important to consider the emotional and practical aspects of parenting. Raising a child requires significant resources, including emotional stability, financial support, and a supportive environment. Given your current mental health challenges, it may be beneficial to evaluate whether you feel prepared for the responsibilities of parenthood. Engaging in discussions with your family, healthcare providers, and possibly a counselor can help you assess your readiness and the support systems available to you.

Lastly, your concerns about the impact of your medications on fetal development are valid. Some psychiatric medications can affect fetal growth and development, leading to potential complications such as congenital malformations or developmental delays. Therefore, it is imperative to have an open dialogue with your healthcare provider about the risks and benefits of continuing or adjusting your medication during pregnancy.

In summary, while it is possible for you to conceive and carry a pregnancy to term, it is essential to approach this decision with careful consideration and professional guidance. Regular consultations with your healthcare team, including both your psychiatrist and an obstetrician, will be crucial in navigating this journey. They can help you make informed decisions about your mental health treatment, monitor your pregnancy closely, and provide support as you consider the implications of parenthood.

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