Abstract
BackgroundThis was a hospital registry-based retrospective age-matched cohort study that aimed to compare pregnancy and neonatal outcomes of women with pre-existing mental disorders with those of mentally healthy women.MethodsA matched cohort retrospective study was carried out in the Department of Obstetrics and Gynecology, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, a tertiary health care institution. Medical records of pregnant women who gave birth from 2006 to 2015 were used. The study group was comprised of 131 pregnant women with mental disorders matched to 228 mentally healthy controls. The primary outcomes assessed were antenatal care characteristics; secondary outcomes were neonatal complications.ResultsPregnant women with pre-existing mental health disorders were significantly more likely to have low education, be unmarried and unemployed, have a disability that led to lower working capacity, smoke more frequently, have chronic concomitant diseases, attend fewer antenatal visits, gain less weight, be hospitalized during pregnancy, spend more time in hospital during the postpartum period, and were less likely to breastfeed their newborns. The newborns of women with pre-existing mental disorders were small for gestational age (SGA) more often than those of healthy controls (12.9% vs. 7.6%, p < 0.05). No difference was found comparing the methods of delivery.ConclusionsWomen with pre-existing mental health disorders had a worse course of pregnancy. Mental illness increased the risk to deliver a SGA newborn (RR 2.055, 95% CI 1.081–3.908).
Highlights
This was a hospital registry-based retrospective age-matched cohort study that aimed to compare pregnancy and neonatal outcomes of women with pre-existing mental disorders with those of mentally healthy women
The World Health Organization recognizes that 10%−16% of pregnant women and 13%−20% of postpartum women worldwide experience mental disorders, and most of these women suffer from depression [1]
There are multiple other factors that increase the probability for adverse delivery outcomes, including genetic predisposition, maternal stress, sociodemographic disadvantage, poor nutrition, addiction to psychoactive substances, and poor antenatal care (ANC) attendance [4,5,6]
Summary
This was a hospital registry-based retrospective age-matched cohort study that aimed to compare pregnancy and neonatal outcomes of women with pre-existing mental disorders with those of mentally healthy women. Mental disorders are among the most common conditions affecting women of reproductive age. Untreated perinatal mental disorders have a significant negative impact on both maternal and fetal health [2]. Because of the changes in women’s neurochemistry caused by identical peptides and proteins synthesized by the brain and the placenta during pregnancy (brain-derived neurotrophic factor, oxytocin, vascular endothelial growth factor, cortisol, matrix metalloproteinase), women with untreated mental disorders (anxiety disorder, posttraumatic stress disorder, schizophrenia, depressive disorders) are at an increased risk of obstetric complications such as preterm birth and delivery of low-birth-weight. Sūdžiūtė et al BMC Pregnancy and Childbirth (2020) 20:419 and small-for-gestational-age (SGA) newborns [3]. Other studies suggest that women with mental illness have a higher rate of overall complications in their pregnancy. The findings on the risk to deliver SGA newborns are not consistent [7,8,9,10,11,12]
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