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Antenatal and postnatal mental health: clinical management and service guidance
- Author:
- NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE
- Publisher:
- National Institute for Health and Clinical Excellence
- Publication year:
- 2007
- Pagination:
- 48p.
- Place of publication:
- London
This NICE guideline makes recommendations for the prediction, detection and treatment of mental disorders in women during pregnancy and the postnatal period (up to 1 year after delivery). It includes advice on the care of women with an existing mental disorder who are planning a pregnancy, and on the organisation of mental health services. The guideline covers the care of women with anxiety disorders, and depression. It also covers the treatment of postnatal psychotic disorders (often referred to as puerperal psychosis), which predominantly comprise bipolar disorder and schizophrenia. It includes advice on the teratogenic risk of psychotropic medications and on the risks of their use during breastfeeding. The focus is on balancing the risks for each woman and her child against those of leaving the mental disorder untreated or inadequately treated. The guidance is based on the best available evidence but points to the limited evidence base in some areas. It is noted that no psychotropic drug has marketing authorisation specifically for pregnant or breastfeeding women. The guideline is intended to be read in conjunction with existing NICE guidance on the treatment and management of mental disorders which also includes advice on the most appropriate organisation of services for the delivery of effective treatment within a stepped-care framework.