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Published in: Archives of Gynecology and Obstetrics 5/2014

01-11-2014 | Maternal-Fetal Medicine

A comparison of maternal and neonatal outcomes of pregnancy with mental disorders: results of an analysis using propensity score-based weighting

Authors: Toshihiro Kitai, Yoshiko Komoto, Reisa Kakubari, Hisashi Konishi, Eriko Tanaka, Saori Nakajima, Miho Muraji, Hiromi Ugaki, Hidenori Matsunaga, Masahiko Takemura

Published in: Archives of Gynecology and Obstetrics | Issue 5/2014

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Abstract

Purpose

To assess and compare maternal and neonatal outcomes of pregnancy with or without mental disorders.

Methods

We performed a retrospective cohort study of births at our institution from January 2009 to December 2011, which included all live singleton births during these 3 years. Women emergently transferred to our institution in the middle of their pregnancies were excluded. Associations between mental disorders and perinatal outcomes were estimated using statistical analysis, and multivariable analysis was performed using propensity score-based weighting.

Results

A total of 1,166 women were included, 152 (13.0 %) of whom had mental disorders. Comparison of maternal characteristics showed that women with mental disorders were significantly more likely to be multiparous, smokers, recipients of public assistance, unmarried, and to have inadequate perinatal care. Comparison of perinatal outcomes showed that preterm births (PTB) before 37 weeks were significantly increased in women with mental disorders (10.5 vs. 6.0 %, P = 0.037). There were no significant differences in low birth weight (LBW), pregnancy-induced hypertension, and gestational diabetes mellitus. Multivariable analysis using propensity score weighting showed that after adjusting for other factors, women with mental disorders were more likely than women without mental disorders to have PTB before 34 weeks [adjusted odds ratio (OR) 4.79, 95 % confidence interval (CI) 1.49–15.4; P = 0.009], PTB before 37 weeks (adjusted OR 2.46, 95 % CI 1.62–3.69; P < 0.001), or LBW (adjusted OR 1.83; 95 % CI 1.32–2.55; P < 0.001).

Conclusion

Maternal mental disorders were associated with adverse birth outcomes and socioeconomic disadvantage.
Literature
2.
go back to reference Rieder RO, Rosenthal D, Wender P, Blumenthal H (1975) The offspring of schizophrenics. Fetal and neonatal deaths. Arch Gen Psychiatry 32:200–211PubMedCrossRef Rieder RO, Rosenthal D, Wender P, Blumenthal H (1975) The offspring of schizophrenics. Fetal and neonatal deaths. Arch Gen Psychiatry 32:200–211PubMedCrossRef
3.
go back to reference Modrzewska K (1980) The offspring of schizophrenic parents in a North Swedish isolate. Clin Genet 17:191–201PubMedCrossRef Modrzewska K (1980) The offspring of schizophrenic parents in a North Swedish isolate. Clin Genet 17:191–201PubMedCrossRef
4.
go back to reference Cannon M, Jones PB, Murray RM (2002) Obstetric complications and schizophrenia: historical and meta-analytic review. Am J Psychiatry 159:1080–1092PubMedCrossRef Cannon M, Jones PB, Murray RM (2002) Obstetric complications and schizophrenia: historical and meta-analytic review. Am J Psychiatry 159:1080–1092PubMedCrossRef
5.
go back to reference Lin HC, Chen YH, Lee HC (2009) Prenatal care and adverse pregnancy outcomes among women with schizophrenia: a nationwide population-based study in Taiwan. J Clin Psychiatry 70:1297–1303PubMedCrossRef Lin HC, Chen YH, Lee HC (2009) Prenatal care and adverse pregnancy outcomes among women with schizophrenia: a nationwide population-based study in Taiwan. J Clin Psychiatry 70:1297–1303PubMedCrossRef
6.
go back to reference Grigoriadis S, VonderPorten EH, Mamisashvili L, Tomlinson G, Dennis CL, Koren G et al (2013) The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and meta-analysis. J Clin Psychiatry 74:e321–e341PubMedCrossRef Grigoriadis S, VonderPorten EH, Mamisashvili L, Tomlinson G, Dennis CL, Koren G et al (2013) The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and meta-analysis. J Clin Psychiatry 74:e321–e341PubMedCrossRef
7.
go back to reference Grote NK, Bridge JA, Gavin AR, Melville JL, Iyengar S, Katon WJ (2010) A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry 67:1012–1024PubMedCrossRefPubMedCentral Grote NK, Bridge JA, Gavin AR, Melville JL, Iyengar S, Katon WJ (2010) A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry 67:1012–1024PubMedCrossRefPubMedCentral
8.
go back to reference Littleton HL, Breitkopf CR, Berenson AB (2007) Correlates of anxiety symptoms during pregnancy and association with perinatal outcomes: a meta-analysis. Am J Obstet Gynecol 196:424–432PubMedCrossRef Littleton HL, Breitkopf CR, Berenson AB (2007) Correlates of anxiety symptoms during pregnancy and association with perinatal outcomes: a meta-analysis. Am J Obstet Gynecol 196:424–432PubMedCrossRef
9.
go back to reference Chen YH, Lin HC, Lee HC (2010) Pregnancy outcomes among women with panic disorder—do panic attacks during pregnancy matter? J Affect Disord 120:258–262PubMedCrossRef Chen YH, Lin HC, Lee HC (2010) Pregnancy outcomes among women with panic disorder—do panic attacks during pregnancy matter? J Affect Disord 120:258–262PubMedCrossRef
10.
go back to reference Hoglund B, Lindgren P, Larsson M (2012) Pregnancy and birth outcomes of women with intellectual disability in Sweden: a national register study. Acta Obstet Gynecol Scand 91:1381–1387PubMedCrossRefPubMedCentral Hoglund B, Lindgren P, Larsson M (2012) Pregnancy and birth outcomes of women with intellectual disability in Sweden: a national register study. Acta Obstet Gynecol Scand 91:1381–1387PubMedCrossRefPubMedCentral
11.
go back to reference Hoglund B, Lindgren P, Larsson M (2012) Newborns of mothers with intellectual disability have a higher risk of perinatal death and being small for gestational age. Acta Obstet Gynecol Scand 91:1409–1414PubMedCrossRefPubMedCentral Hoglund B, Lindgren P, Larsson M (2012) Newborns of mothers with intellectual disability have a higher risk of perinatal death and being small for gestational age. Acta Obstet Gynecol Scand 91:1409–1414PubMedCrossRefPubMedCentral
12.
go back to reference Micali N, De Stavola B, dos-Santos-Silva I, Steenweg-de Graaff J, Jansen PW, Jaddoe VW et al (2012) Perinatal outcomes and gestational weight gain in women with eating disorders: a population-based cohort study. BJOG 119:1493–5102PubMedCrossRef Micali N, De Stavola B, dos-Santos-Silva I, Steenweg-de Graaff J, Jansen PW, Jaddoe VW et al (2012) Perinatal outcomes and gestational weight gain in women with eating disorders: a population-based cohort study. BJOG 119:1493–5102PubMedCrossRef
13.
go back to reference Micali N, Simonoff E, Treasure J (2007) Risk of major adverse perinatal outcomes in women with eating disorders. Br J Psychiatry 190:255–259PubMedCrossRef Micali N, Simonoff E, Treasure J (2007) Risk of major adverse perinatal outcomes in women with eating disorders. Br J Psychiatry 190:255–259PubMedCrossRef
14.
go back to reference American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, revised, 4th edn. American Psychiatric Association, Washington, DC American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, revised, 4th edn. American Psychiatric Association, Washington, DC
15.
go back to reference Vesga-López O, Blanco C, Keyes K, Olfson M, Grant BF, Hasin DS (2008) Psychiatric disorders in pregnant and postpartum women in the United States. Arch Gen Psychiatry 65:805–815PubMedCrossRefPubMedCentral Vesga-López O, Blanco C, Keyes K, Olfson M, Grant BF, Hasin DS (2008) Psychiatric disorders in pregnant and postpartum women in the United States. Arch Gen Psychiatry 65:805–815PubMedCrossRefPubMedCentral
16.
go back to reference Howard LM, Goss C, Leese M, Thornicroft G (2003) Medical outcome of pregnancy in women with psychotic disorders and their infants in the first year after birth. Br J Psychiatry 182:63–67PubMedCrossRef Howard LM, Goss C, Leese M, Thornicroft G (2003) Medical outcome of pregnancy in women with psychotic disorders and their infants in the first year after birth. Br J Psychiatry 182:63–67PubMedCrossRef
18.
go back to reference Scott WJ, Matteotti RS, Egleston BL, Oseni S, Flaherty JF (2010) A comparison of perioperative outcomes of video-assisted thoracic surgical (VATS) lobectomy with open thoracotomy and lobectomy: results of an analysis using propensity score based weighting. Ann Surg Innov Res 4:1PubMedCrossRefPubMedCentral Scott WJ, Matteotti RS, Egleston BL, Oseni S, Flaherty JF (2010) A comparison of perioperative outcomes of video-assisted thoracic surgical (VATS) lobectomy with open thoracotomy and lobectomy: results of an analysis using propensity score based weighting. Ann Surg Innov Res 4:1PubMedCrossRefPubMedCentral
19.
go back to reference MacKenzie EJ, Rivara FP, Jurkovich GJ, Nathens AB, Frey KP, Egleston BL et al (2006) A national evaluation of the effect of trauma-center care on mortality. N Engl J Med 354:366–378PubMedCrossRef MacKenzie EJ, Rivara FP, Jurkovich GJ, Nathens AB, Frey KP, Egleston BL et al (2006) A national evaluation of the effect of trauma-center care on mortality. N Engl J Med 354:366–378PubMedCrossRef
21.
go back to reference Goodwin RD, Keyes K, Simuro N (2007) Mental disorders and nicotine dependence among pregnant women in the United States. Obstet Gynecol 109:875–883PubMedCrossRef Goodwin RD, Keyes K, Simuro N (2007) Mental disorders and nicotine dependence among pregnant women in the United States. Obstet Gynecol 109:875–883PubMedCrossRef
22.
go back to reference Lasser K, Boyd JW, Woolhandler S, Himmelstein DU, McCormick D, Bor DH (2000) Smoking and mental illness: a population-based prevalence study. JAMA 284:2606–2610PubMedCrossRef Lasser K, Boyd JW, Woolhandler S, Himmelstein DU, McCormick D, Bor DH (2000) Smoking and mental illness: a population-based prevalence study. JAMA 284:2606–2610PubMedCrossRef
23.
go back to reference Borders AE, Grobman WA, Amsden LB, Holl JL (2007) Chronic stress and low birth weight neonates in a low-income population of women. Obstet Gynecol 109(2 Pt 1):331–338PubMedCrossRef Borders AE, Grobman WA, Amsden LB, Holl JL (2007) Chronic stress and low birth weight neonates in a low-income population of women. Obstet Gynecol 109(2 Pt 1):331–338PubMedCrossRef
24.
go back to reference Herbert TB, Cohen S (1993) Stress and immunity in humans: a meta-analytic review. Psychosom Med 55:364–379PubMedCrossRef Herbert TB, Cohen S (1993) Stress and immunity in humans: a meta-analytic review. Psychosom Med 55:364–379PubMedCrossRef
25.
go back to reference Howard LM, Bekele D, Rowe M, Demilew J, Bewley S, Marteau TM (2013) Smoking cessation in pregnant women with mental disorders: a cohort and nested qualitative study. BJOG 120:362–370PubMedCrossRefPubMedCentral Howard LM, Bekele D, Rowe M, Demilew J, Bewley S, Marteau TM (2013) Smoking cessation in pregnant women with mental disorders: a cohort and nested qualitative study. BJOG 120:362–370PubMedCrossRefPubMedCentral
26.
go back to reference Polakowski LL, Akinbami LJ, Mendola P (2009) Prenatal smoking cessation and the risk of delivering preterm and small-for-gestational-age newborns. Obstet Gynecol 114(2 Pt 1):318–325PubMedCrossRef Polakowski LL, Akinbami LJ, Mendola P (2009) Prenatal smoking cessation and the risk of delivering preterm and small-for-gestational-age newborns. Obstet Gynecol 114(2 Pt 1):318–325PubMedCrossRef
27.
go back to reference Lamont RF, Nhan-Chang CL, Sobel JD, Workowski K, Conde-Agudelo A, Romero R (2011) Treatment of abnormal vaginal flora in early pregnancy with clindamycin for the prevention of spontaneous preterm birth: a systematic review and meta-analysis. Am J Obstet Gynecol 205:177–190PubMedCrossRefPubMedCentral Lamont RF, Nhan-Chang CL, Sobel JD, Workowski K, Conde-Agudelo A, Romero R (2011) Treatment of abnormal vaginal flora in early pregnancy with clindamycin for the prevention of spontaneous preterm birth: a systematic review and meta-analysis. Am J Obstet Gynecol 205:177–190PubMedCrossRefPubMedCentral
28.
go back to reference Leitich H, Bodner-Adler B, Brunbauer M, Kaider A, Egarter C, Husslein P (2003) Bacterial vaginosis as a risk factor for preterm delivery: a meta-analysis. Am J Obstet Gynecol 189:139–147PubMedCrossRef Leitich H, Bodner-Adler B, Brunbauer M, Kaider A, Egarter C, Husslein P (2003) Bacterial vaginosis as a risk factor for preterm delivery: a meta-analysis. Am J Obstet Gynecol 189:139–147PubMedCrossRef
29.
go back to reference Polyzos NP, Polyzos IP, Zavos A, Valachis A, Mauri D, Papanikolaou EG et al (2010) Obstetric outcomes after treatment of periodontal disease during pregnancy: systematic review and meta-analysis. BMJ 341:c7017PubMedCrossRefPubMedCentral Polyzos NP, Polyzos IP, Zavos A, Valachis A, Mauri D, Papanikolaou EG et al (2010) Obstetric outcomes after treatment of periodontal disease during pregnancy: systematic review and meta-analysis. BMJ 341:c7017PubMedCrossRefPubMedCentral
30.
go back to reference Xiong X, Buekens P, Fraser WD, Beck J, Offenbacher S (2006) Periodontal disease and adverse pregnancy outcomes: a systematic review. BJOG 113:135–143PubMedCrossRef Xiong X, Buekens P, Fraser WD, Beck J, Offenbacher S (2006) Periodontal disease and adverse pregnancy outcomes: a systematic review. BJOG 113:135–143PubMedCrossRef
31.
go back to reference Stephansson O, Kieler H, Haglund B, Artama M, Engeland A, Furu K et al (2013) Selective serotonin reuptake inhibitors during pregnancy and risk of stillbirth and infant mortality. JAMA 309:48–54PubMedCrossRef Stephansson O, Kieler H, Haglund B, Artama M, Engeland A, Furu K et al (2013) Selective serotonin reuptake inhibitors during pregnancy and risk of stillbirth and infant mortality. JAMA 309:48–54PubMedCrossRef
32.
go back to reference Alwan S, Reefhuis J, Rasmussen SA, Olney RS, Friedman JM, National Birth Defects Prevention Study (2007) Use of selective serotonin-reuptake inhibitors in pregnancy and the risk of birth defects. N Engl J Med 356:2684–2692PubMedCrossRef Alwan S, Reefhuis J, Rasmussen SA, Olney RS, Friedman JM, National Birth Defects Prevention Study (2007) Use of selective serotonin-reuptake inhibitors in pregnancy and the risk of birth defects. N Engl J Med 356:2684–2692PubMedCrossRef
Metadata
Title
A comparison of maternal and neonatal outcomes of pregnancy with mental disorders: results of an analysis using propensity score-based weighting
Authors
Toshihiro Kitai
Yoshiko Komoto
Reisa Kakubari
Hisashi Konishi
Eriko Tanaka
Saori Nakajima
Miho Muraji
Hiromi Ugaki
Hidenori Matsunaga
Masahiko Takemura
Publication date
01-11-2014
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 5/2014
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-014-3304-7

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