The prevalence of schizophrenia in the normal population is 1%; the prevalence of schizophrenia in children born to a husband and wife with schizophrenia is 1/10; the prevalence of schizophrenia in children born to a husband and wife with schizophrenia is 4/10. Therefore, the prevalence of schizophrenia in children born to a husband and wife with schizophrenia is 10 times that of the normal population. If both spouses have schizophrenia, the prevalence of schizophrenia in their children is 40 times higher than that of the general population. Therefore, we believe that both men and women with schizophrenia should not get married, and if they are married, they should not have children. If one spouse has schizophrenia and the other is mentally normal, they can get married. As for childbirth, some parents believe that since the heritability rate is 10 times higher than that of normal people, the risk of heredity to the next generation is too great, and since it is already difficult for the patient to take care of himself/herself because of his/her illness, it would be too much for the family to bear the burden if he/she were to pass it on to the next generation. However, not to have children is not only an important decision, but also seriously affect the way of life in the second half of life, watching neighbors add children, hold grandchildren, pick up kindergarten, pick up elementary school, their own free hair, see the neighboring children to see their parents on New Year’s holidays, their own home is cold and quiet, there is a kind of unexplainable loneliness, to the twilight years, one old partner died first, another old partner became a widowed elderly. Is afraid to have children with 1/10 chance of disease, or afraid of old age 100% do five households, the patient can choose for themselves. Yu Dongshan believes that it is better to risk the 1/10th chance of having a child with the disease than to be a permanent member of a five-income family in his old age. What’s more, schizophrenia patients who are in remission to a level where they can get married and have children should be among those who are in better remission. Even if their children are unfortunate enough to hit that 1/10 chance of developing schizophrenia in the future, their symptoms, outcome and prognosis are similar to those of genetic parties, theoretically speaking, the prognosis is not that bad. Second, when is it appropriate for women with schizophrenia to get pregnant An ironclad view is that it is not advisable to get pregnant even if the schizophrenia is not in remission and the family is anxious to have children. After the remission of schizophrenia, the patient before the age of 30 (including 30 years old), it is recommended to wait for two years after the remission of the disease before getting pregnant. The reason is that after remission, the first six months of treatment medication is gradually reduced to the lowest effective amount so that the possible effects of medication on the fetus are minimized, and the second 1.5 years allow the patient to gradually resume social functioning and lay the foundation for actively implementing pregnancy health guidance after pregnancy to promote healthy fetal development. When another pregnancy occurs over the age of 35, the placenta ages and calcium deposits, affecting the blood supply to the fetus, which in turn affects the development of the fetus. Therefore, the first pregnancy over 35 years of age is called advanced primigravida, which is an indicator of the impact on fetal development. After remission of schizophrenia, the patient reaches 31 years of age or older, it is recommended to get pregnant after half a year of remission, the reason being that after half a year, you are already 31.5 years old, and then put 2 years to plan a pregnancy (couples who have lived together for more than 2 years without having children are called sterile, so putting 2 years is enough), you are already 33.5 years old, and then you are pregnant for 40 weeks (more than 9 months), you are already 34 years old and approaching 35 years old. If at this time still insist on 2 years after the remission of the disease before pregnancy, then at least 33 years old to plan a pregnancy, even if by 2 years when the pregnancy begins, it will be into or over 35 years old. Third, do antipsychotics during pregnancy cause teratology? The U.S. Food and Drug Administration classifies clozapine as a Class B pregnancy drug, that is, no danger has been found in humans, while other antipsychotics are classified as Class C pregnancy drugs, that is, the danger cannot be ruled out. In the end, it is not certain that other antipsychotics cause or do not cause teratogenicity. Even if it is not certain, drugs that have been used for a long time are clinically safer than drugs that have been used for a short time because no teratogenic findings have been observed for drugs that have been used for a long time, indicating that it is more likely to be safe. Therefore, older generation antipsychotics (or typical antipsychotics) are safer than newer generation antipsychotics (or atypical antipsychotics). The prototype of the older generation antipsychotics is chlorpromazine, and the rate of severe teratogenicity is 3.5%, which is within the range of 2% to 4% of the rate of severe teratogenicity in the general population, so it is still safe. It has been shown that Endrin 6 mg twice a day or less is safe. Although there are constant case reports of what kind of antipsychotics can cause malformations during pregnancy (for example, haloperidol causes multiple limb malformations), do not forget that the general population also has a serious teratogenic rate of 2% to 4%, and as long as the teratogenic rate of the antipsychotics taken does not exceed 2% to 4%, you cannot say that they are caused by antipsychotics. 4. Should I take or not take antipsychotics during pregnancy? Schizophrenia patients in complete remission do not take antipsychotics during pregnancy, of course, there is no teratogenic concern, but the relapse rate of schizophrenia is 1/7, because the risk of fetal teratogenicity has not been proven, while the risk of relapse is real, the pros and cons are weighed, we recommend that pregnancy with medication, how much dose of pregnancy with medication is considered safe? We believe that moderate doses (Thorazine 400 mg/day) or less are safer. If you ask your psychiatrist, you may get the answer: “Pregnancy without medication definitely increases the risk of recurrence of the disease, and it is difficult to say whether taking medication has any effect on the fetus, and there is no guarantee that it is not teratogenic”, and you ask: “So should I take medication with pregnancy or not? You doctor give me a clear answer”, the doctor replied: “This is a dilemma, do not take the drug will be morbid, we do not agree; take the drug may cause teratogenic, we can not guarantee the safety, it is best not to get pregnant, or you family members to decide for themselves”. Why are doctors so slick and vague? The main fear is that the patient’s family blame them: pregnant without drugs, the onset of disease, fear of the patient’s family will say, you told us to stop drugs before the onset of disease; pregnant with drugs, the birth of a deformed child, fear of the patient’s family to come, you said not teratogenic it? This child for you to raise, leaving the deformed child on the go. In fact, as long as the literature does not clearly report the drug teratogenic, even if you take the drug to give birth to a deformed child, it can not be said to be caused by the drug, normal people do not also have 2% to 4% of the rate of severe malformations? If the patient’s family is unreasonable and bites you, asking you to produce clear evidence that the drug is not teratogenic, tell him that although I cannot produce clear proof that the drug is not teratogenic, you cannot produce evidence that the drug is teratogenic either, and in the case of uncertainty about teratogenicity, what we can make clear is that the drug is effective in preventing the patient’s schizophrenia, and on the balance of pros and cons, it is reasonable for us to recommend that you carry the drug to pregnancy at that time.