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首页> 外文期刊>The Australian and New Zealand journal of psychiatry >Mood stabilizers in pregnancy and child developmental outcomes: A systematic review
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Mood stabilizers in pregnancy and child developmental outcomes: A systematic review

机译：怀孕和儿童发展结果中的情绪稳定剂：系统评价

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Background: Research suggests that maintaining treatment during pregnancy for women with bipolar affective disorder reduces the risk of relapse. However, one of the key questions for women and clinicians during pregnancy is whether there are implications of exposure to mood stabilizers for longer term child development. Despite these concerns, there are few recent systematic reviews comparing the impact on child developmental outcomes for individual mood-stabilizing agents to inform clinical decisions. Objectives: To examine the strengths and limitations of the existing data on child developmental outcomes following prenatal exposure to mood stabilizers and to explore whether there are any differences between agents for detrimental effects on child development. Method: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a rigorous systematic search was carried out of four electronic databases from their respective years of inception to September 2016 to identify studies which examined the effects of mood stabilizers including sodium valproate, carbamazepine, lamotrigine, lithium and second-generation antipsychotics on child developmental outcomes. Results: We identified 15 studies for critical review. Of these, 10 examined antiepileptic drugs, 2 studied lithium and 3 studied second-generation antipsychotics. The most consistent finding was a dose–response relationship for valproate with higher doses associated with poorer global cognitive abilities compared to other antiepileptic drugs. The limited data available for lithium found no adverse neurodevelopmental outcomes. The limited second-generation antipsychotic studies included a report of a transient early neurodevelopmental delay which resolved by 12?months of age. Conclusion: This review found higher neurodevelopmental risk with valproate. While the existing data on lithium and second-generation antipsychotics are reassuring, these data are both limited and lower quality, indicating that further research is required. The information from this review is relevant for patients and clinicians to influence choice of mood-stabilizing agent in childbearing women. This must be balanced against the known risks associated with untreated bipolar affective disorder. ]]>
机译：背景：研究表明，双相情感障碍患者在怀孕期间坚持治疗可降低复发风险。然而，孕妇和临床医生在怀孕期间面临的一个关键问题是，接触情绪稳定剂是否会对儿童的长期发展产生影响。尽管存在这些担忧，但最近很少有系统性综述比较个体情绪稳定剂对儿童发育结果的影响，以指导临床决策。目的：检查关于产前暴露于情绪稳定剂后儿童发育结果的现有数据的优势和局限性，并探讨不同因素对儿童发育的不利影响是否存在差异。方法：使用系统评价和荟萃分析指南的首选报告项目，从四个电子数据库的成立年份到2016年9月，对它们进行了严格的系统搜索，以确定检查心境稳定剂效果的研究，包括丙戊酸钠、卡马西平、拉莫三嗪、，锂和第二代抗精神病药物对儿童发育的影响。结果：我们确定了15项研究进行批判性审查。其中，10名受试者服用了抗癫痫药物，2名受试者服用了锂，3名受试者服用了第二代抗精神病药物。最一致的发现是丙戊酸钠的剂量-反应关系，与其他抗癫痫药物相比，丙戊酸钠的剂量越高，整体认知能力越差。锂的有限可用数据未发现不良的神经发育结果。有限的第二代抗精神病药物研究包括一个短暂的早期神经发育延迟的报告，该延迟在12？几个月大。结论：本综述发现丙戊酸钠具有更高的神经发育风险。虽然锂和第二代抗精神病药物的现有数据令人放心，但这些数据既有限又质量较低，这表明还需要进一步研究。这篇综述中的信息与患者和临床医生影响育龄妇女情绪稳定剂的选择有关。这必须与未经治疗的双相情感障碍相关的已知风险相平衡。]]>

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