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Published in: Maternal and Child Health Journal 5/2012

01-07-2012

Neonatal Outcomes and Mental Illness, Substance Abuse, and Intentional Injury During Pregnancy

Authors: Anna Wiencrot, Angela Nannini, Susan E. Manning, Joan Kennelly

Published in: Maternal and Child Health Journal | Issue 5/2012

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Abstract

Mental illness (MI), substance abuse (SA), and intentional injury (II) are known individual risk factors for adverse pregnancy outcomes. Their combined association with preterm birth (PTB) and low birth weight (LBW) remains relatively unexplored. We examined hospital utilization for the co-occurrence of II and MI or SA in pregnant women in Massachusetts and assessed their interactive association with PTB and LBW. This retrospective cohort study used ICD-9 and E-codes reported on linked birth and hospital utilization data to identify MI, SA, and II diagnoses during pregnancy for 176,845 Massachusetts resident women who delivered during 2002–2004. Adjusted odds ratios (OR) for the independent and joint associations of MI, SA, and II on PTB and LBW were calculated. Two thousand two hundred and eight women (1.6%) had a prenatal MI visit, 834 (0.5%) a prenatal SA visit, and 847 (0.5%) a prenatal II visit. Among them 163 women had MI and II visits and 69 had SA and II visits. SA, MI, and II were all significant predictors of LBW and PTB. Women with both SA and II had higher odds of PTB (OR 2.7 95% CI 1.3–5.7) and LBW (OR 5.3 95% CI 3.9–7.3) than women with neither diagnosis. Prenatal MI, SA, and II are risk factors for LBW and PTB. Women with SA and II co-diagnoses have greater risk of LBW and PTB than women with neither diagnosis. Screening, timely diagnosis, and treatment of women with co-occurring morbidities, particularly II and SA, should be incorporated into reproductive and perinatal health programs.
Literature
1.
go back to reference Bennett, H. A., Einarson, A., Taddio, A., Koren, G., & Einarson, T. R. (2004). Prevalence of depression during pregnancy: Systematic review. Obstetrics and Gynecology, 103(4), 698–709.PubMedCrossRef Bennett, H. A., Einarson, A., Taddio, A., Koren, G., & Einarson, T. R. (2004). Prevalence of depression during pregnancy: Systematic review. Obstetrics and Gynecology, 103(4), 698–709.PubMedCrossRef
2.
go back to reference Marcus, S. M., Flynn, H. A., Blow, F. C., & Barry, K. L. (2003). Depressive symptoms among pregnant women screened in obstetrics settings. Journal of Womens Health (Larchmt), 12(4), 373–380.CrossRef Marcus, S. M., Flynn, H. A., Blow, F. C., & Barry, K. L. (2003). Depressive symptoms among pregnant women screened in obstetrics settings. Journal of Womens Health (Larchmt), 12(4), 373–380.CrossRef
3.
go back to reference Gavin, N. I., Gaynes, B. N., Lohr, K. N., Meltzer-Brody, S., Gartlehner, G., & Swinson, T. (2005). Perinatal depression: A systematic review of prevalence and incidence. Obstetrics and Gynecology, 106(5 Pt 1), 1071–1083.PubMedCrossRef Gavin, N. I., Gaynes, B. N., Lohr, K. N., Meltzer-Brody, S., Gartlehner, G., & Swinson, T. (2005). Perinatal depression: A systematic review of prevalence and incidence. Obstetrics and Gynecology, 106(5 Pt 1), 1071–1083.PubMedCrossRef
4.
go back to reference Dayan, J., Creveuil, C., Herlicoviez, M., Herbel, C., Baranger, E., Savoye, C., et al. (2002). Role of anxiety and depression in the onset of spontaneous preterm labor. American Journal of Epidemiology, 155(4), 293–301.PubMedCrossRef Dayan, J., Creveuil, C., Herlicoviez, M., Herbel, C., Baranger, E., Savoye, C., et al. (2002). Role of anxiety and depression in the onset of spontaneous preterm labor. American Journal of Epidemiology, 155(4), 293–301.PubMedCrossRef
5.
go back to reference Hoffman, S., & Hatch, M. C. (2000). Depressive symptomatology during pregnancy: Evidence for an association with decreased fetal growth in pregnancies of lower social class women. Health Psychology, 19(6), 535–543.PubMedCrossRef Hoffman, S., & Hatch, M. C. (2000). Depressive symptomatology during pregnancy: Evidence for an association with decreased fetal growth in pregnancies of lower social class women. Health Psychology, 19(6), 535–543.PubMedCrossRef
6.
go back to reference Kelly, R. H., Russo, J., Holt, V. L., Danielsen, B. H., Zatzick, D. F., Walker, E., et al. (2002). Psychiatric and substance use disorders as risk factors for low birth weight and preterm delivery. Obstetrics and Gynecology, 100(2), 297–304.PubMedCrossRef Kelly, R. H., Russo, J., Holt, V. L., Danielsen, B. H., Zatzick, D. F., Walker, E., et al. (2002). Psychiatric and substance use disorders as risk factors for low birth weight and preterm delivery. Obstetrics and Gynecology, 100(2), 297–304.PubMedCrossRef
7.
go back to reference Orr, S. T., James, S. A., & Blackmore Prince, C. (2002). Maternal prenatal depressive symptoms and spontaneous preterm births among African-American women in Baltimore, Maryland. American Journal of Epidemiology, 156(9), 797–802.PubMedCrossRef Orr, S. T., James, S. A., & Blackmore Prince, C. (2002). Maternal prenatal depressive symptoms and spontaneous preterm births among African-American women in Baltimore, Maryland. American Journal of Epidemiology, 156(9), 797–802.PubMedCrossRef
8.
go back to reference Steer, R. A., Scholl, T. O., Hediger, M. L., & Fischer, R. L. (1992). Self-reported depression and negative pregnancy outcomes. Journal of Clinical Epidemiology, 45(10), 1093–1099.PubMedCrossRef Steer, R. A., Scholl, T. O., Hediger, M. L., & Fischer, R. L. (1992). Self-reported depression and negative pregnancy outcomes. Journal of Clinical Epidemiology, 45(10), 1093–1099.PubMedCrossRef
9.
go back to reference MacCabe, J. H., Martinsson, L., Lichtenstein, P., Nilsson, E., Cnattingius, S., Murray, R. M., et al. (2007). Adverse pregnancy outcomes in mothers with affective psychosis. Bipolar Disorder, 9(3), 305–309.CrossRef MacCabe, J. H., Martinsson, L., Lichtenstein, P., Nilsson, E., Cnattingius, S., Murray, R. M., et al. (2007). Adverse pregnancy outcomes in mothers with affective psychosis. Bipolar Disorder, 9(3), 305–309.CrossRef
10.
go back to reference Miller, L. J. (2001). Psychiatric disorders during pregnancy. In N. L. Stotland & D. E. Steward (Eds.), Psychological aspects of women’s health care: The interface between psychiatry and obstetrics and gynecology, (pp. 51–66). Miller, L. J. (2001). Psychiatric disorders during pregnancy. In N. L. Stotland & D. E. Steward (Eds.), Psychological aspects of women’s health care: The interface between psychiatry and obstetrics and gynecology, (pp. 51–66).
11.
go back to reference Nilsson, E., Lichtenstein, P., Cnattingius, S., Murray, R. M., & Hultman, C. M. (2002). Women with schizophrenia: Pregnancy outcome and infant death among their offspring. Schizophrenic Research, 58(2–3), 221–229.CrossRef Nilsson, E., Lichtenstein, P., Cnattingius, S., Murray, R. M., & Hultman, C. M. (2002). Women with schizophrenia: Pregnancy outcome and infant death among their offspring. Schizophrenic Research, 58(2–3), 221–229.CrossRef
12.
go back to reference Lester, B. M., Andreozzi, L., & Appiah, L. (2004). Substance use during pregnancy: Time for policy to catch up with research. Harm Reduction Journal, 1(5), 1–44. Lester, B. M., Andreozzi, L., & Appiah, L. (2004). Substance use during pregnancy: Time for policy to catch up with research. Harm Reduction Journal, 1(5), 1–44.
14.
go back to reference Bailey, B. A., & Sokol, R. J. (2008). Pregnancy and alcohol use: Evidence and recommendations for prenatal care. Clinical Obstetrics and Gynecology, 51(2), 436.PubMedCrossRef Bailey, B. A., & Sokol, R. J. (2008). Pregnancy and alcohol use: Evidence and recommendations for prenatal care. Clinical Obstetrics and Gynecology, 51(2), 436.PubMedCrossRef
15.
go back to reference Zuckerman, B., Frank, D. & Brown, E. (1995). Overview of the effects of abuse and drugs on pregnancy and offspring. In C. N. Chiang & L. P. Finnegan (Eds.), Medications development for the treatment of pregnant addicts and their infants (pp. 16–38). Rockville, MD: National Institute on Drug Abuse. NIDA research monograph 149. NIH publication no. 953891. Zuckerman, B., Frank, D. & Brown, E. (1995). Overview of the effects of abuse and drugs on pregnancy and offspring. In C. N. Chiang & L. P. Finnegan (Eds.), Medications development for the treatment of pregnant addicts and their infants (pp. 16–38). Rockville, MD: National Institute on Drug Abuse. NIDA research monograph 149. NIH publication no. 953891.
16.
go back to reference Shankaran, S., Lester, B. M., Das, A., Bauer, C. R., Bada, H. S., Lagasse, L., et al. (2007). Impact of maternal substance use during pregnancy on childhood outcome. Seminar in Fetal and Neonatal Medicine, 12(2), 143–150.CrossRef Shankaran, S., Lester, B. M., Das, A., Bauer, C. R., Bada, H. S., Lagasse, L., et al. (2007). Impact of maternal substance use during pregnancy on childhood outcome. Seminar in Fetal and Neonatal Medicine, 12(2), 143–150.CrossRef
17.
go back to reference Gazmararian, J. A., Lazorick, S., Spitz, A. M., Ballard, T. J., Saltzman, L. E., & Marks, J. S. (1996). Prevalence of violence against pregnant women. JAMA, 275(24), 1915–1920.PubMedCrossRef Gazmararian, J. A., Lazorick, S., Spitz, A. M., Ballard, T. J., Saltzman, L. E., & Marks, J. S. (1996). Prevalence of violence against pregnant women. JAMA, 275(24), 1915–1920.PubMedCrossRef
18.
go back to reference Nannini, A., Lazar, J., Berg, C., Barger, M., Tomashek, K., Cabral, H., et al. (2008). Physical injuries reported on hospital visits for assault during the pregnancy-associated period. Nursing Research, 57(3), 144.PubMedCrossRef Nannini, A., Lazar, J., Berg, C., Barger, M., Tomashek, K., Cabral, H., et al. (2008). Physical injuries reported on hospital visits for assault during the pregnancy-associated period. Nursing Research, 57(3), 144.PubMedCrossRef
19.
go back to reference Boy, A., & Salihu, H. M. (2004). Intimate partner violence and birth outcomes: A systematic review. International Journal of Fertility and Womens Medicine, 49(4), 159–164. Boy, A., & Salihu, H. M. (2004). Intimate partner violence and birth outcomes: A systematic review. International Journal of Fertility and Womens Medicine, 49(4), 159–164.
20.
go back to reference Amaro, H. (1990). Violence during pregnancy and substance use. American Journal of Public Health, 80(5), 575–579.PubMedCrossRef Amaro, H. (1990). Violence during pregnancy and substance use. American Journal of Public Health, 80(5), 575–579.PubMedCrossRef
21.
go back to reference Martin, S. L., Beaumont, J. L., & Kupper, L. L. (2003). Substance use before and during pregnancy: Links to intimate partner violence. American Journal of Drug and Alcohol Abuse, 29(3), 599–617.PubMedCrossRef Martin, S. L., Beaumont, J. L., & Kupper, L. L. (2003). Substance use before and during pregnancy: Links to intimate partner violence. American Journal of Drug and Alcohol Abuse, 29(3), 599–617.PubMedCrossRef
22.
go back to reference Martin, S. L. (1996). Violence and substance use among North Carolina pregnant women. American Journal of Public Health, 86(7), 991–998.PubMedCrossRef Martin, S. L. (1996). Violence and substance use among North Carolina pregnant women. American Journal of Public Health, 86(7), 991–998.PubMedCrossRef
23.
go back to reference Martin, S. L., Kilgallen, B., Dee, D. L., Dawson, S., & Campbell, J. (1998). Women in a prenatal care/substance abuse treatment program: Links between domestic violence and mental health. Maternal and Child Health Journal, 2(2), 85–94.PubMedCrossRef Martin, S. L., Kilgallen, B., Dee, D. L., Dawson, S., & Campbell, J. (1998). Women in a prenatal care/substance abuse treatment program: Links between domestic violence and mental health. Maternal and Child Health Journal, 2(2), 85–94.PubMedCrossRef
24.
go back to reference Martin, S. L., Clark, K. A., Lynch, S. R., Kupper, L. L., & Cilenti, D. (1999). Violence in the lives of pregnant teenage women: Associations with multiple substance use. Americal Journal of Drug and Alcohol Abuse, 25(3), 425–440.CrossRef Martin, S. L., Clark, K. A., Lynch, S. R., Kupper, L. L., & Cilenti, D. (1999). Violence in the lives of pregnant teenage women: Associations with multiple substance use. Americal Journal of Drug and Alcohol Abuse, 25(3), 425–440.CrossRef
25.
go back to reference Horrigan, T. J., Schroeder, A. V., & Schaffer, R. M. (2000). The triad of substance abuse, violence, and depression are interrelated in pregnancy. Journal of Substance Abuse Treatment, 18(1), 55–58.PubMedCrossRef Horrigan, T. J., Schroeder, A. V., & Schaffer, R. M. (2000). The triad of substance abuse, violence, and depression are interrelated in pregnancy. Journal of Substance Abuse Treatment, 18(1), 55–58.PubMedCrossRef
26.
go back to reference Velez, M. L., Montoya, I. D., Jansson, L. M., Walters, V., Svikis, D., Jones, H. E., et al. (2006). Exposure to violence among substance-dependent pregnant women and their children. Journal of Substance Abuse Treatment, 30(1), 31–38.PubMedCrossRef Velez, M. L., Montoya, I. D., Jansson, L. M., Walters, V., Svikis, D., Jones, H. E., et al. (2006). Exposure to violence among substance-dependent pregnant women and their children. Journal of Substance Abuse Treatment, 30(1), 31–38.PubMedCrossRef
27.
go back to reference Hedin, L. W., & Janson, P. O. (2000). Domestic violence during pregnancy. The prevalence of physical injuries, substance use, abortions and miscarriages. Acta Obstetricia at Gynecologica Scandinavica, 79, 625–630. Hedin, L. W., & Janson, P. O. (2000). Domestic violence during pregnancy. The prevalence of physical injuries, substance use, abortions and miscarriages. Acta Obstetricia at Gynecologica Scandinavica, 79, 625–630.
28.
go back to reference Tuten, M., Jones, H. E., Tran, G., & Svikis, D. S. (2004). Partner violence impacts the psychosocial and psychiatric status of pregnant, drug-dependent women. Addictive Behaviors, 29(5), 1029–1034.PubMedCrossRef Tuten, M., Jones, H. E., Tran, G., & Svikis, D. S. (2004). Partner violence impacts the psychosocial and psychiatric status of pregnant, drug-dependent women. Addictive Behaviors, 29(5), 1029–1034.PubMedCrossRef
29.
go back to reference Bacchus, L., Mezey, G., & Bewley, S. (2003). Domestic violence: Prevalence in pregnant women and associations with physical and psychological health. European Journal of Obstetrics and Gynecology and Reproductive Biology, 113, 6–11.CrossRef Bacchus, L., Mezey, G., & Bewley, S. (2003). Domestic violence: Prevalence in pregnant women and associations with physical and psychological health. European Journal of Obstetrics and Gynecology and Reproductive Biology, 113, 6–11.CrossRef
30.
go back to reference Lovisi, G. M., Lopez, J. R. R. A., Coutinho, E. S. F., & Patel, V. (2005). Poverty, violence and depression during pregnancy: A survey of mothers attending a public hospital in Brazil. Psychology Medicine, 35(10), 1485–1492.CrossRef Lovisi, G. M., Lopez, J. R. R. A., Coutinho, E. S. F., & Patel, V. (2005). Poverty, violence and depression during pregnancy: A survey of mothers attending a public hospital in Brazil. Psychology Medicine, 35(10), 1485–1492.CrossRef
31.
go back to reference Ferri, C. P., Mitsuhiro, S. S., Barros, M. C., Chalem, E., Guinsburg, R., Patel, V., et al. (2007). The impact of maternal experience of violence and common mental disorders on neonatal outcomes: A survey of adolescent mothers in Sao Paulo, Brazil. BMC Public Health., 7, 209.PubMedCrossRef Ferri, C. P., Mitsuhiro, S. S., Barros, M. C., Chalem, E., Guinsburg, R., Patel, V., et al. (2007). The impact of maternal experience of violence and common mental disorders on neonatal outcomes: A survey of adolescent mothers in Sao Paulo, Brazil. BMC Public Health., 7, 209.PubMedCrossRef
32.
go back to reference Rosen, D., Seng, J. S., Tolman, R. M., & Mallinger, G. (2007). Intimate partner violence, depression, and posttraumatic stress disorder as additional predictors of low birth weight infants among low-income mothers. Journal of Interpersonal Violence, 22(10), 1305.PubMedCrossRef Rosen, D., Seng, J. S., Tolman, R. M., & Mallinger, G. (2007). Intimate partner violence, depression, and posttraumatic stress disorder as additional predictors of low birth weight infants among low-income mothers. Journal of Interpersonal Violence, 22(10), 1305.PubMedCrossRef
33.
go back to reference Rodriguez, M. A., Heilemann, M. S. V., Fielder, E., Ang, A., Nevarez, F., & Mangione, C. M. (2008). Intimate partner violence, depression, and PTSD among pregnant Latina women. The Annals of Family Medicine, 6(1), 44–52.CrossRef Rodriguez, M. A., Heilemann, M. S. V., Fielder, E., Ang, A., Nevarez, F., & Mangione, C. M. (2008). Intimate partner violence, depression, and PTSD among pregnant Latina women. The Annals of Family Medicine, 6(1), 44–52.CrossRef
34.
go back to reference Clements, K. M., Barfield, W. D., Kotelchuck, M., Lee, K. G., & Wilber, N. (2006). Birth characteristics associated with early intervention referral, evaluation for eligibility, and program eligibility in the first year of life. Maternal and Child Health Journal, 10(5), 433–441.PubMedCrossRef Clements, K. M., Barfield, W. D., Kotelchuck, M., Lee, K. G., & Wilber, N. (2006). Birth characteristics associated with early intervention referral, evaluation for eligibility, and program eligibility in the first year of life. Maternal and Child Health Journal, 10(5), 433–441.PubMedCrossRef
35.
go back to reference Weiss, H. B. (1995). Pregnancy-associated injury hospitalizations in Pennsylvania. Annals of Emergency Medicine, 1999;34, 5. Weiss, H. B. (1995). Pregnancy-associated injury hospitalizations in Pennsylvania. Annals of Emergency Medicine, 1999;34, 5.
37.
go back to reference Lawrence, B. A., Miller, T. R., Weiss, H. B., & Spicer, R. S. (2007). Issues in using state hospital discharge data in injury control research and surveillance. Accident Analysis and Prevention, 39(2), 319–325.PubMedCrossRef Lawrence, B. A., Miller, T. R., Weiss, H. B., & Spicer, R. S. (2007). Issues in using state hospital discharge data in injury control research and surveillance. Accident Analysis and Prevention, 39(2), 319–325.PubMedCrossRef
38.
go back to reference Dietz, P. M., England, L., Callaghan, W. M., Pearl, M., Wier, M. L., & Kharrazi, M. (2007). A comparison of LMP-based and ultrasound-based estimates of gestational age using linked California live birth and prenatal screening records. Paediatric and Perinat Epidemiol, 21(Suppl. 2), 62–71.CrossRef Dietz, P. M., England, L., Callaghan, W. M., Pearl, M., Wier, M. L., & Kharrazi, M. (2007). A comparison of LMP-based and ultrasound-based estimates of gestational age using linked California live birth and prenatal screening records. Paediatric and Perinat Epidemiol, 21(Suppl. 2), 62–71.CrossRef
41.
go back to reference Tolman, R. M., & Rosen, D. (2001). Domestic violence in the lives of women receiving welfare: Mental health, substance dependency and economic well-being. Violence Against Women., 7, 141–158. Tolman, R. M., & Rosen, D. (2001). Domestic violence in the lives of women receiving welfare: Mental health, substance dependency and economic well-being. Violence Against Women., 7, 141–158.
42.
go back to reference Domino, M. E., Morrissey, J. P., Chung, S., Huntington, N., Larson, M. J., & Russell, L. A. (2005). Service use and costs for women with co-occurring mental and substance use disorders and a history of violence. Psychiatric Services, 56(10), 1223.PubMedCrossRef Domino, M. E., Morrissey, J. P., Chung, S., Huntington, N., Larson, M. J., & Russell, L. A. (2005). Service use and costs for women with co-occurring mental and substance use disorders and a history of violence. Psychiatric Services, 56(10), 1223.PubMedCrossRef
43.
go back to reference Morrissey, J. P., Jackson, E. W., Ellis, A. R., Amaro, H., Brown, V. B., & Najavits, L. M. (2005). Twelve-month outcomes of trauma-informed interventions for women with co-occurring disorders. Psychiatric Services, 56(10), 1213.PubMedCrossRef Morrissey, J. P., Jackson, E. W., Ellis, A. R., Amaro, H., Brown, V. B., & Najavits, L. M. (2005). Twelve-month outcomes of trauma-informed interventions for women with co-occurring disorders. Psychiatric Services, 56(10), 1213.PubMedCrossRef
Metadata
Title
Neonatal Outcomes and Mental Illness, Substance Abuse, and Intentional Injury During Pregnancy
Authors
Anna Wiencrot
Angela Nannini
Susan E. Manning
Joan Kennelly
Publication date
01-07-2012
Publisher
Springer US
Published in
Maternal and Child Health Journal / Issue 5/2012
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI
https://doi.org/10.1007/s10995-011-0821-x

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