Preliminary findings from the National Register of Antipsychotic Medication in Pregnancy.
OBJECTIVE
Following the presentation of a case study and an overview of current data highlighting the need for further research into the use of antipsychotic medication during pregnancy, the aim of the present paper was to outline the establishment of, and present preliminary data from, the National Register of Antipsychotic Medication in Pregnancy (NRAMP).


METHODS
Australian women with a history of psychosis, including schizophrenia, bipolar affective disorder with psychosis, schizoaffective disorder and first-episode psychosis, who are pregnant, are currently being invited to participate. The confluence of speculated national pregnancy rates and epidemiological data regarding child-bearing-age women with psychosis suggested an enrollment target of 100 women over a 24 month period. Details of antipsychotic medication are recorded throughout the pregnancy and for 1 year postnatally. Interviews with the mother are conducted 6 weekly antenatally, and then at 6 and 12 weeks, and 6 and 12 months postnatally, to assess symptoms of psychosis and depression, and attitudes towards parenting. In addition, consultations are conducted with the women's health-care providers to collate information regarding pharmacology and related side-effects, obstetric outcomes, psychiatric diagnoses and symptoms during pregnancy and for 1 year after delivery, and the provision of details on the baby's health and well-being.


RESULTS
NRAMP was launched in 2005. Ethics approvals have been gained at 14 sites nationally. Thirty women have consented, and 11 have completed. Data including demographics, health-care provision and medication for the first 30 participants are presented.


CONCLUSIONS
The establishment of NRAMP is an important strategy in improving the management of serious mental illness such as schizophrenia and related disorders, in women who are pregnant. This project involves extensive collaboration between many different clinical groups and industry, and shall culminate in an important resource to improve the quality of life for both patients and future generations.
Alfred Psychiatry Research Centre, Level 1, Old Baker Building, Alfred Hospital, Melbourne, Vic, Australia 3004. jayashri.kulkarni@med.monash.edu.au
Jayashri
J
Kulkarni
Kay
K
McCauley-Elsom
Natasha
N
Marston
Heather
H
Gilbert
Caroline
C
Gurvich
Anthony
A
de Castella
Paul
P
Fitzgerald
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001315:Australia; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D002746:Chlorpromazine / Q000009:adverse effects / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D003625:Data Collection / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D000077152:Olanzapine; D010672:Phenytoin / Q000009:adverse effects / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D012042:Registries / Q000706:statistics & numerical data*; D012307:Risk Factors; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy; D013405:Suicide / Q000523:psychology
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D010672:Phenytoin; D000077152:Olanzapine; D002746:Chlorpromazine