Archives of Gynecology and Obstetrics

, Volume 290, Issue 5, pp 883–889 | Cite as

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

  • Toshihiro Kitai
  • Yoshiko Komoto
  • Reisa Kakubari
  • Hisashi Konishi
  • Eriko Tanaka
  • Saori Nakajima
  • Miho Muraji
  • Hiromi Ugaki
  • Hidenori Matsunaga
  • Masahiko Takemura
Maternal-Fetal Medicine
First Online:
Received:
Accepted:

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.

Keywords

Psychiatric disorders Perinatal outcome Mental illness 
This is a preview of subscription content, log in to check access.

Notes

Acknowledgments

We thank Kouji Yamamoto (Medical Center for Translational and Clinical Research, Osaka University) for his excellent technical assistance. We thank Clinical Research Support Team in Jichi Medical University for their advice.

Conflict of interest

The authors report no potential conflicts of interest.

References

  1. 1.
    Japanese Ministry of Health, Labour and Welfare (2013) Data on mental illness. http://www.mhlw.go.jp/kokoro/speciality/data.html. Accessed 12 Nov 2013
  2. 2.
    Rieder RO, Rosenthal D, Wender P, Blumenthal H (1975) The offspring of schizophrenics. Fetal and neonatal deaths. Arch Gen Psychiatry 32:200–211PubMedCrossRefGoogle Scholar
  3. 3.
    Modrzewska K (1980) The offspring of schizophrenic parents in a North Swedish isolate. Clin Genet 17:191–201PubMedCrossRefGoogle Scholar
  4. 4.
    Cannon M, Jones PB, Murray RM (2002) Obstetric complications and schizophrenia: historical and meta-analytic review. Am J Psychiatry 159:1080–1092PubMedCrossRefGoogle Scholar
  5. 5.
    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 70:1297–1303PubMedCrossRefGoogle Scholar
  6. 6.
    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–e341PubMedCrossRefGoogle Scholar
  7. 7.
    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 67:1012–1024PubMedCrossRefPubMedCentralGoogle Scholar
  8. 8.
    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 196:424–432PubMedCrossRefGoogle Scholar
  9. 9.
    Chen YH, Lin HC, Lee HC (2010) Pregnancy outcomes among women with panic disorder—do panic attacks during pregnancy matter? J Affect Disord 120:258–262PubMedCrossRefGoogle Scholar
  10. 10.
    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 91:1381–1387PubMedCrossRefPubMedCentralGoogle Scholar
  11. 11.
    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 91:1409–1414PubMedCrossRefPubMedCentralGoogle Scholar
  12. 12.
    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 119:1493–5102PubMedCrossRefGoogle Scholar
  13. 13.
    Micali N, Simonoff E, Treasure J (2007) Risk of major adverse perinatal outcomes in women with eating disorders. Br J Psychiatry 190:255–259PubMedCrossRefGoogle Scholar
  14. 14.
    American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, revised, 4th edn. American Psychiatric Association, Washington, DCGoogle Scholar
  15. 15.
    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 65:805–815PubMedCrossRefPubMedCentralGoogle Scholar
  16. 16.
    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 182:63–67PubMedCrossRefGoogle Scholar
  17. 17.
    Japanese Ministry of Health, Labour and Welfare (2012) For your well-being during pregnancy and delivery. http://www.mhlw.go.jp/bunya/kodomo/boshi-hoken10/dl/02.pdf. Accessed 21 Jan 2014
  18. 18.
    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 4:1PubMedCrossRefPubMedCentralGoogle Scholar
  19. 19.
    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 354:366–378PubMedCrossRefGoogle Scholar
  20. 20.
    Japanese Ministry of Health, Labour and Welfare (2010) Data of birth. http://www.mhlw.go.jp/toukei/saikin/hw/hoken/kiso/xls/21-2-38.xls. Accessed 21 Jan 2014
  21. 21.
    Goodwin RD, Keyes K, Simuro N (2007) Mental disorders and nicotine dependence among pregnant women in the United States. Obstet Gynecol 109:875–883PubMedCrossRefGoogle Scholar
  22. 22.
    Lasser K, Boyd JW, Woolhandler S, Himmelstein DU, McCormick D, Bor DH (2000) Smoking and mental illness: a population-based prevalence study. JAMA 284:2606–2610PubMedCrossRefGoogle Scholar
  23. 23.
    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):331–338PubMedCrossRefGoogle Scholar
  24. 24.
    Herbert TB, Cohen S (1993) Stress and immunity in humans: a meta-analytic review. Psychosom Med 55:364–379PubMedCrossRefGoogle Scholar
  25. 25.
    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 120:362–370PubMedCrossRefPubMedCentralGoogle Scholar
  26. 26.
    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):318–325PubMedCrossRefGoogle Scholar
  27. 27.
    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 205:177–190PubMedCrossRefPubMedCentralGoogle Scholar
  28. 28.
    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 189:139–147PubMedCrossRefGoogle Scholar
  29. 29.
    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:c7017PubMedCrossRefPubMedCentralGoogle Scholar
  30. 30.
    Xiong X, Buekens P, Fraser WD, Beck J, Offenbacher S (2006) Periodontal disease and adverse pregnancy outcomes: a systematic review. BJOG 113:135–143PubMedCrossRefGoogle Scholar
  31. 31.
    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 309:48–54PubMedCrossRefGoogle Scholar
  32. 32.
    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 356:2684–2692PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Toshihiro Kitai
    • 1
  • Yoshiko Komoto
    • 1
  • Reisa Kakubari
    • 1
  • Hisashi Konishi
    • 1
  • Eriko Tanaka
    • 1
  • Saori Nakajima
    • 1
  • Miho Muraji
    • 1
  • Hiromi Ugaki
    • 1
  • Hidenori Matsunaga
    • 2
  • Masahiko Takemura
    • 1
  1. 1.Department of Obstetrics and GynecologyOsaka General Medical CenterOsakaJapan
  2. 2.Department of PsychiatryOsaka General Medical CenterOsakaJapan

Personalised recommendations