515: Perinatal outcomes among women with mood disorders: a retrospective population-based cohort study

Abstract

ObjectiveTo investigate whether the risks of adverse perinatal outcomes is elevated among pregnant women with mood disorders compared to women with no diagnosed mental illness.Study DesignWe completed a population-based cohort study of pregnant women in Ontario, between 2002 and 2011. Bipolar (n=1859) and major depressive (n=3724) disorders were identified among women with at least one inpatient diagnosis for the respective diagnoses within 5 years prior to conception. The reference group comprised 432,358 women with no documented mental illness during the same pre-pregnancy period. The main adverse perinatal outcomes included preterm birth < 37 weeks gestation, birth weight > 97th or < 3rd percentile for gestational age, stillbirth and early infant death within 28 days after birth. Outcomes were adjusted for maternal age, parity, pre-pregnancy medical morbidity and infant sex. Additional perinatal health outcome indicators were secondary outcomes.ResultsRelative to a rate of 6.2% in the referent, the risk of preterm was higher in women with bipolar disorder (adjusted odds ratio [AOR] 2.01, 95% confidence interval [CI] 1.73 to 2.33), and those with major depressive group (AOR 1.96, 95% CI 1.76 to 2.18). The AOR for small gestational age were 1.15 (95% CI 0.92 to 1.44) and 1.22 (95% CI 1.05 to 1.42), respectively. The AOR for large gestational age were 1.34 (95% CI 1.05 to 1.70) and 1.01 (95% CI 1.01 to 1.02), respectively. Neonatal mortality did not differ significantly between groups. Serious neonatal morbidity, malformations and neonatal re-admission rates were significantly increased in each mood disorder group, relative to women with no mental illness.ConclusionWomen with mood disorders are at an increased risk for multiple adverse perinatal outcomes. Adverse outcome rates in women with depressive and bipolar disorders were similar, suggesting that the commonalities to these disorders may be more important to maternal and child outcomes, than the differences. ObjectiveTo investigate whether the risks of adverse perinatal outcomes is elevated among pregnant women with mood disorders compared to women with no diagnosed mental illness. To investigate whether the risks of adverse perinatal outcomes is elevated among pregnant women with mood disorders compared to women with no diagnosed mental illness. Study DesignWe completed a population-based cohort study of pregnant women in Ontario, between 2002 and 2011. Bipolar (n=1859) and major depressive (n=3724) disorders were identified among women with at least one inpatient diagnosis for the respective diagnoses within 5 years prior to conception. The reference group comprised 432,358 women with no documented mental illness during the same pre-pregnancy period. The main adverse perinatal outcomes included preterm birth < 37 weeks gestation, birth weight > 97th or < 3rd percentile for gestational age, stillbirth and early infant death within 28 days after birth. Outcomes were adjusted for maternal age, parity, pre-pregnancy medical morbidity and infant sex. Additional perinatal health outcome indicators were secondary outcomes. We completed a population-based cohort study of pregnant women in Ontario, between 2002 and 2011. Bipolar (n=1859) and major depressive (n=3724) disorders were identified among women with at least one inpatient diagnosis for the respective diagnoses within 5 years prior to conception. The reference group comprised 432,358 women with no documented mental illness during the same pre-pregnancy period. The main adverse perinatal outcomes included preterm birth < 37 weeks gestation, birth weight > 97th or < 3rd percentile for gestational age, stillbirth and early infant death within 28 days after birth. Outcomes were adjusted for maternal age, parity, pre-pregnancy medical morbidity and infant sex. Additional perinatal health outcome indicators were secondary outcomes. ResultsRelative to a rate of 6.2% in the referent, the risk of preterm was higher in women with bipolar disorder (adjusted odds ratio [AOR] 2.01, 95% confidence interval [CI] 1.73 to 2.33), and those with major depressive group (AOR 1.96, 95% CI 1.76 to 2.18). The AOR for small gestational age were 1.15 (95% CI 0.92 to 1.44) and 1.22 (95% CI 1.05 to 1.42), respectively. The AOR for large gestational age were 1.34 (95% CI 1.05 to 1.70) and 1.01 (95% CI 1.01 to 1.02), respectively. Neonatal mortality did not differ significantly between groups. Serious neonatal morbidity, malformations and neonatal re-admission rates were significantly increased in each mood disorder group, relative to women with no mental illness. Relative to a rate of 6.2% in the referent, the risk of preterm was higher in women with bipolar disorder (adjusted odds ratio [AOR] 2.01, 95% confidence interval [CI] 1.73 to 2.33), and those with major depressive group (AOR 1.96, 95% CI 1.76 to 2.18). The AOR for small gestational age were 1.15 (95% CI 0.92 to 1.44) and 1.22 (95% CI 1.05 to 1.42), respectively. The AOR for large gestational age were 1.34 (95% CI 1.05 to 1.70) and 1.01 (95% CI 1.01 to 1.02), respectively. Neonatal mortality did not differ significantly between groups. Serious neonatal morbidity, malformations and neonatal re-admission rates were significantly increased in each mood disorder group, relative to women with no mental illness. ConclusionWomen with mood disorders are at an increased risk for multiple adverse perinatal outcomes. Adverse outcome rates in women with depressive and bipolar disorders were similar, suggesting that the commonalities to these disorders may be more important to maternal and child outcomes, than the differences. Women with mood disorders are at an increased risk for multiple adverse perinatal outcomes. Adverse outcome rates in women with depressive and bipolar disorders were similar, suggesting that the commonalities to these disorders may be more important to maternal and child outcomes, than the differences.