wileyonlinelibrary.com/journal/anzjog 1 © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists DOI: 10.1111/ajo.12621 ORIGINAL ARTICLE The efects of gestational use of antidepressants and antipsychotics on neonatal outcomes for women with severe mental illness Jacqueline Frayne 1,2 , Thinh Nguyen 3,4 , Kellie Bennett 3 , Suzanna Allen 1 , Yvonne Hauck 5,6 and Helena Liira 2 Aust N Z J Obstet Gynaecol 2017; 1–7 1 Department of Obstetrics and Gynaecology, King Edward Memorial Hospital, Subiaco, Western Australia, Australia 2 School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Crawley, Western Australia, Australia 3 School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Western Australia, Australia 4 Peel and Rockingham Kwinana Mental Health Services, Rockingham, Western Australia, Australia 5 Department of Nursing and Midwifery Education, King Edward Memorial Hospital, Subiaco, Western Australia, Australia 6 School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia Correspondence: Jacqueline Frayne, Childbirth and Mental Illness Antenatal Clinic, King Edward Memorial Hospital, 374 Bagot Road, Subiaco, WA 6008, Australia. Email: Jacqueline.frayne@uwa.edu.au Conficts of interest: none. Received: 15 August 2016; Accepted: 1 February 2017 Background: Psychotropic medication use occurs in 8% of pregnancies, with rates increasing, and often multiple medications prescribed. Aims: This study aims to determine if the use of psychotropic medication, in a cohort of women with severe mental illness, increases rates of special care nurs- ery admission and reports diferences between antidepressant and antipsychotic medication use either alone or in combination. Methods: A retrospective database analysis from a cohort with severe mental illness in pregnancy identifed 268 pregnant women who were grouped accord- ing to medication type. Demographic, obstetric and neonatal variables were ana- lysed using t-tests, χ 2 , analysis of variance and logistic regression analysis for special care nursery admission. Results: The medication groups consisted of: women taking no psychotropic medications (n = 67); those taking antipsychotics (n = 87); those taking antide- pressants (n = 55); those taking and a combination of antidepressants/antipsy- chotics (n = 59). Rates of special care nursery admission in women who took psychotropic medication (41.3%) were elevated compared to those who did not (26.9%) (P = 0.035), and were signifcantly raised when compared to the general population (P < 0.000). No signifcant diference occurred between the medica- tion groups. A signifcant adjusted odds ratio of 2.79 (95% CI 1.286–6.049) was found for special care nursery and psychiatric admission during pregnancy but not for psychotropic medication. Conclusion: Rates of special care nursery admission are elevated in neonates of women with severe mental illness taking psychotropic medication, but were not diferent for monotherapy or polytherapy when prescribing antidepressants or an- tipsychotic medication. Additional vulnerability occurs in the neonates of women with a mental illness and paediatric presence at delivery is recommended. KEYWORDS neonatal outcomes, antidepressant, antipsychotic medication, special care nursery, pregnancy