@article{GehrmannFiedlerLeutritzetal.2021, author = {Gehrmann, Andrea and Fiedler, Katrin and Leutritz, Anna Linda and Koreny, Carolin and Kittel-Schneider, Sarah}, title = {Lithium medication in pregnancy and breastfeeding — a case series}, series = {Medicina}, volume = {57}, journal = {Medicina}, number = {6}, issn = {1648-9144}, doi = {10.3390/medicina57060634}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-285640}, year = {2021}, abstract = {Lithium salts are the first-line prophylaxis treatment for bipolar disorder in most guidelines. The majority of bipolar women are treated with mood stabilizers at the time they wish to get pregnant. One reason for this is the rising average age at first childbirth, at least in the high-income countries, which increases in general the likelihood of a medication with psychotropic drugs. Previously, lithium exposition during pregnancy was thought to strongly increase the risk of severe cardiac malformation. However, recent studies only point to a low teratogenic risk, so nowadays an increasing number of women are getting pregnant with ongoing lithium treatment. Regarding lithium medication during breastfeeding, there is evidence that lithium transfers to the breastmilk and can also be detected in the infants' serum. The influence on the infant is still a largely understudied topic. Regular monitoring of the infants' renal clearance, thyroid function, and lithium levels is warranted when breastfeeding under lithium exposure. In this case series, we present three case reports of bipolar mothers who were treated with lithium during pregnancy and breastfeeding to add to the scarce literature on this important topic. In short, we strengthen the importance of therapeutic drug monitoring due to fluctuating plasma levels during pregnancy and after birth, and we can report the birth and development of three healthy infants despite lithium medication during pregnancy and breastfeeding.}, language = {en} } @article{LeutritzvanBraamPreisetal.2023, author = {Leutritz, Anna Linda and van Braam, Lara and Preis, Katharina and Gehrmann, Andrea and Scherf-Clavel, Maike and Fiedler, Katrin and Unterecker, Stefan and Kittel-Schneider, Sarah}, title = {Psychotropic medication in pregnancy and lactation and early development of exposed children}, series = {British Journal of Clinical Pharmacology}, volume = {89}, journal = {British Journal of Clinical Pharmacology}, number = {2}, doi = {10.1111/bcp.15533}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-318954}, pages = {737 -- 750}, year = {2023}, abstract = {There is still limited knowledge about alterations of blood concentrations of psychotropic drugs during pregnancy, the transfer of psychotropic drugs into breastmilk and the effects on exposed children. We investigated changes in concentrations of psychopharmacological medication during pregnancy and lactation in serum and breastmilk at different time points in a naturalistic sample of 60 mothers and observed the development of the exposed children in the first 12 months. We found a decrease in serum concentrations from the first to the second trimester of amitriptyline, duloxetine, escitalopram, quetiapine and sertraline. Citalopram stayed rather stable during pregnancy, sertraline levels interestingly increased again from the second to the third trimester. High concentration-by-dose ratios in breastmilk were found for venlafaxine as well as lamotrigine, low for quetiapine and clomipramine. Similarly, clomipramine and quetiapine showed low milk/serum-penetration ratios. Regarding the birth outcome measures in children, we found no significant differences between in utero exposed compared to nonexposed newborns. There were no significant differences in the development in the first 12 months. Psychotropic medication in the peripartum needs a balancing of risks and benefits and a continuous therapeutic drug monitoring can be a guidance for clinicians to monitor drug alteration patterns, which are likely to occur due to physiological pregnancy-associated changes in pharmacokinetics. Accordingly, therapeutic drug monitoring can optimize a medication in pregnancy and lactation with the lowest effective dose.}, language = {en} } @article{HuebnerWolfgangTheisetal.2022, author = {H{\"u}bner, Theresa and Wolfgang, Tanja and Theis, Ann-Catrin and Steber, Magdalena and Wiedenmann, Lea and W{\"o}ckel, Achim and Diessner, Joachim and Hein, Grit and Gr{\"u}ndahl, Marthe and K{\"a}mmerer, Ulrike and Kittel-Schneider, Sarah and Bartmann, Catharina}, title = {The impact of the COVID-19 pandemic on stress and other psychological factors in pregnant women giving birth during the first wave of the pandemic}, series = {Reproductive Health}, volume = {19}, journal = {Reproductive Health}, number = {1}, doi = {10.1186/s12978-022-01493-9}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-300189}, year = {2022}, abstract = {Background The onset of mental illness such as depression and anxiety disorders in pregnancy and postpartum period is common. The coronavirus induced disease 2019 (COVID-19) pandemic and the resulting public policy responses represent an exceptional situation worldwide and there are hints for adverse psychosocial impact, hence, the study of psychological effects of the pandemic in women during hospitalization for delivery and in the postpartum period is highly relevant. Methods Patients who gave birth during the first wave of the COVID-19 pandemic in Germany (March to June 2020) at the Department of Obstetrics and Gynecology, University of W{\"u}rzburg, Germany, were recruited at hospital admission for delivery. Biosamples were collected for analysis of SARS-CoV-2 infection and various stress hormones and interleukin-6 (IL-6). In addition to sociodemographic and medical obstetric data, survey questionnaires in relation to concerns about and fear of COVID-19, depression, stress, anxiety, loneliness, maternal self-efficacy and the mother-child bonding were administered at T1 (delivery stay) and T2 (3-6 months postpartum). Results In total, all 94 recruited patients had a moderate concern of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at T1 with a significant rise at T2. This concern correlated with low to low-medium general psychosocial stress levels and stress symptoms, and the women showed a significant increase of active coping from T1 to T2. Anxiety levels were low and the Edinburgh Postnatal Depression Scale showed a medium score of 5 with a significant (T1), but only week correlation with the concerns about SARS-CoV-2. In contrast to the overall good maternal bonding without correlation to SARS-CoV-2 concern, the maternal self-efficiency correlated negatively with the obstetric impairment caused by the COVID-19 pandemic. Conclusion Obstetric patients` concerns regarding SARS-CoV-2 and the accompanying pandemic increased during the course of the pandemic correlating positively with stress and depression. Of note is the increase in active coping over time and the overall good mother-child-bonding. Maternal self-efficacy was affected in part by the restrictions of the pandemic.}, language = {en} } @article{StoeberFranzekBeckmann1992, author = {St{\"o}ber, Gerald and Franzek, E. and Beckmann, H.}, title = {The role of maternal infectious diseases during pregnancy in the etiology of schizophrenia in offspring}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-82216}, year = {1992}, abstract = {In 55 chronic schizophrenics, the occurrence of infectious diseases during their mothers' pregnancies was investigated. Different psychiatrie diagnostic systems were compared. Infections were reported by the mothers of familial and sporadic DSM I1I-R schizophrenics in equal proportion. However, applying Leonhard's classification, the frequency of infections was found to be significantly increased in 'systematic' schizophrenia (mainly exogenously induced in the view of Leonhard) compared to 'unsystematic' schizophrenia (mainly genetically determined according to Leonhard's findings). Most of the infections occurred during the second trimester (nine out of 13). Thus, in the 'systematic' forms of schizophrenia (low genetic loading), maternal infections in this crucial period of neurodevelopment would appear to be important causative factors in the cytoarchitectural deviance detected in the central nervous system of schizophrenics.}, subject = {Psychiatrie}, language = {en} }