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Impact of a prenatal episode and diagnosis in women with serious mental illnesses on neonatal complications (prematurity, low birth weight, and hospitalization in neonatal intensive care units)

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Abstract

Pregnancy in women with mental disorders is increasingly common. The aim of this study was to determine, in women with severe mental illnesses, whether a prenatal episode was related to neonatal complications and if a specific disorder was associated with a higher risk. A population of infants and their mothers (n = 1439) jointly admitted to psychiatric Mother-Baby Units in France and Belgium (2001–2010) was assessed respectively for prematurity, low birth weight (LBW), hospitalization in neonatal intensive care units (NICUs), and maternal mental health during pregnancy. Logistic regression was used to explore the association between neonatal complications and a prenatal episode of mental illness and if the presence of a specific disorder was related to a higher risk, taking into account maternal socio-demographic characteristics, pregnancy data, and antenatal exposure to psychotropic drugs. Among the children, 145 (10.2%) were premature, 226 (15.8%) had a LBW, and 348 (24.3%) have been hospitalized in neonatology. The presence of an episode of mental illness during pregnancy was linked to LBW (OR = 2.21 [1.44–3.38]; p = 0.003) and NICU hospitalizations (OR = 1.53 [1.06–2.19], p = 0.002). Among diagnoses, the presence of a severe substance use disorder in these women was related to LBW (OR = 2.96 [1.49–5.85]; p = 0.002) and NICU (OR = 2.88 [1.56–5.29]; p = 0.04). Our results underline the importance of systematic and early detection of psychiatric symptoms and substance use disorders during pregnancy in preventing neonatal complications in women with serious mental illness.

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Acknowledgments

The authors thank the members of MBUs: Bordeaux, Montesson, Strasbourg, Le Vesinet, Créteil, Villejuif, Paris, Brussels, Limoges, Ottiginies, Marseille, Gent, Lille, Besançon, Albi, and Brumath who contributed to data collection, and the women who participated in the study.

Funding

The study received financial support from the Francophone Marcé Society.

Author information

Author notes

  1. Anne-Laure Sutter-Dallay and Florence Gressier contributed equally to this work.

Authors and Affiliations

  1. Department of Psychiatry, Assistance Publique-Hôpitaux de Paris, Bicêtre University Hospital, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France

    Reda Boukakiou & Florence Gressier

  2. INSERM Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Biostatistics (U1153), Paris Descartes University, Paris, France

    Nine M. C. Glangeaud-Freudenthal

  3. Department of Biostatistics, Maison de Solenn, Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM U1178, 97 Bld de Port-Royal, 75679, Paris Cedex 14, France

    Bruno Falissard

  4. Research Center Inserm 1219, Bordeaux Population Health Bordeaux University, University Department of Adult Psychiatry, Charles-Perrens Hospital, 33000, Bordeaux, France

    Anne-Laure Sutter-Dallay

  5. Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM U1178, Bicêtre University Hospital, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France

    Florence Gressier

Authors
  1. Reda Boukakiou
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  2. Nine M. C. Glangeaud-Freudenthal
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  3. Bruno Falissard
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  4. Anne-Laure Sutter-Dallay
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  5. Florence Gressier
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Corresponding author

Correspondence to Florence Gressier.

Ethics declarations

All selected women provided informed consent for their inclusion in the database. The study was performed in accordance with the ethics standards of the French National Data Protection Authority (CNIL) which the CNIL approved the study.

Conflicts of interest

Regarding potential conflicts of interest, all of them were indirect:

Reda Boukakiou, Nine Glangeaud-Feudenthal, and Anne-Laure Sutter-Dallay report no financial relationships with commercial interests.

Bruno Falissard has been a consultant, expert, or has given talks for E. Lilly, BMS, Servier, Sanofi, GlaxoSmithKline, HRA, Roche, Boeringer Ingelheim, Bayer, Almirall, Allergan, Stallergene, Genzyme, Pierre Fabre, Astra Zeneca, Novartis, Janssen, Astellas, Biotronik, Daiichi-Sankyo, Gilead, MSD, and Lundbeck. Florence Gressier has given talks for Lundbeck and Servier and received a grant from Servier for a postdoctoral degree (2011–2012).

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Boukakiou, R., Glangeaud-Freudenthal, N.M.C., Falissard, B. et al. Impact of a prenatal episode and diagnosis in women with serious mental illnesses on neonatal complications (prematurity, low birth weight, and hospitalization in neonatal intensive care units). Arch Womens Ment Health 22, 439–446 (2019). https://doi.org/10.1007/s00737-018-0915-1

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