Electronic Thesis and Dissertation Repository


Master of Science


Epidemiology and Biostatistics


Anderson, Kelly K.


Navigating psychotropic treatment use for bipolar disorder (BD) in pregnancy is challenging as it is, but it is even more difficult with use of multiple medications across various drug classes for treatment, given the absence of evidence of their safe use. This retrospective cohort study assessed prescription patterns, patient characteristics associated with these patterns, risk of adverse outcomes, and rates of readmission in women with BD who were prescribed antipsychotic, antidepressant, or combination treatment during pregnancy, relative to untreated women. An estimated 25% of women were prescribed psychotropic drugs during pregnancy. Women with past suicide attempts and those with recurrence(s) during pregnancy were more likely to be prescribed antipsychotics only, whereas women with a history of alcohol-related disorders were less likely. Women with obesity related disorders were less likely to be prescribed antidepressants alone in pregnancy. The number of prior psychiatric emergency department visits was associated with use of combination antipsychotic and antidepressant therapy. This study found no statistically significant association between type of treatments prescribed and perinatal and psychiatric outcomes.