The goal of prenatal care is a healthy pregnancy and prevention of adverse maternal and fetal outcomes. Women with schizophrenia who become pregnant pose unique challenges to the delivery of prenatal care and are at high risk for adverse perinatal outcomes. Pregnancy in these women should be considered high risk.
Offspring of women with schizophrenia are genetically predisposed to developing schizophrenia. Obstetric complications such as diabetes, prematurity, and fetal growth retardation also place the offspring at greater risk for development of schizophrenia, regardless of the genetic vulnerability. Pregnant women with schizophrenia are at greater risk for inadequate prenatal care and known obstetric complications, which are further risk factors for schizophrenia in the offspring. Thus, the genetic and obstetric environment of the fetus predisposes to the development of schizophrenia. This risk may be mitigated by increased vigilance in providing prenatal care to these women and preventing or minimizing illness and treatment emergent complications during pregnancy.
In this article we review: 1) the barriers to adequate prenatal care in women with schizophrenia, 2) factors associated with the illness and its treatment requiring attention and monitoring during prenatal visits, and 3) the multi-disciplinary, collaborative approach to the delivery of prenatal care for these women.