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The impact of neuropsychiatric disease on fetal growth: a case–control study

  • Lara Südekum
  • Anke Redlich
  • Anja Radusch
  • Sven Seeger
  • Siegfried Kropf
  • Ligang Zhou
  • Serban-Dan Costa
  • Gerhard Jorch
  • Anke RissmannEmail author
Maternal-Fetal Medicine
  • 15 Downloads

Abstract

Purpose

To determine the impact of depression, epilepsy and drug abuse during pregnancy on delivery and fetal outcome. Due to the worldwide increasing prevalence of neurological and psychiatric diseases and drug abuse, the number of affected pregnant women is increasing.

Methods

A large-scale retrospective case–control analysis of pregnancies affected by depression, epilepsy or drug abuse with and without medication was conducted in two German perinatal centres between 2013 and 2017. The case group consisted of 706 pregnant women who had a diagnosis of depression, epilepsy or drug abuse vs. 12,574 pregnant women without neuropsychiatric diagnosis (control group). The analysis included the rate of intrauterine growth restriction, birth weight and length, neonatal head circumference.

Results

Significant differences in the subgroups were found in the parameters intrauterine growth restriction, birth weight, length and head circumference. Women with epilepsy were affected less often than women with depression and substance abuse. Major differences were found in the group of women with substance abuse. Negative associations were found within the non-pharmacologically managed disease group itself compared to women exposed to medication.

Conclusion

The present results demonstrated a negative association between maternal neurological or psychiatric disease and pregnancy outcome in the examined parameters. However, the non-pharmacologically treated maternal disease was identified as a risk factor itself.

Keywords

Germany Case–control study Neuropsychiatric disease Pregnancy outcome Perinatal outcome Birth parameters 

Notes

Author contributions

GJ: critical revision of the article, final approval. SDC: critical revision of the article, final approval. SK: statistical support, critical revision of the article, final approval. SS: data collection, critical revision of the article, final approval. AR: data collection, critical revision of the article, final approval. AR: data collection, critical revision of the article, final approval. LZ: data collection, critical revision of the article, final approval. AR: project development, data collection, data analysis and interpretation, critical revision of the article, final approval. LS: project development, data collection, data analysis and interpretation, manuscript writing.

Funding

This paper was Lara Südekum’s doctoral thesis, and she obtained financial support from the Otto-von-Guericke-University Medical Faculty Magdeburg, Germany, as a doctoral scholarship.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The institutional Ethics Committee of the Medical Faculty of the Otto-von-Guericke University Magdeburg (113/14), Germany approved the study. All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

For this retrospective type of study formal consent was not required. Requirement for inform consent has been waived by the institutional Ethics Committee due to the retrospective nature of the study, and pseudonymization of data.

References

  1. 1.
    Yang J, Kang C, Li J et al (2017) A three-decade repeated cross-sectional survey on mental health of the Chinese Jino minority. Aust N Z J Psychiatry 51(11):1134–1141.  https://doi.org/10.1177/0004867416682599 CrossRefPubMedGoogle Scholar
  2. 2.
    Yin H, Xu G, Tian H et al (2017) The prevalence, age-of-onset and the correlates of DSM-IV psychiatric disorders in the Tianjin Mental Health Survey (TJMHS). Psychol Med.  https://doi.org/10.1017/S0033291717001878 CrossRefPubMedGoogle Scholar
  3. 3.
    Hammond I, Eastman AL, Leventhal JM et al. (2017) Maternal Mental Health Disorders and Reports to Child Protective Services: A Birth Cohort Study. Int J Environ Res Public Health 14(11). 10.3390/ijerph14111320Google Scholar
  4. 4.
    Eastwood J, Ogbo FA, Hendry A et al (2017) The impact of antenatal depression on perinatal outcomes in Australian women. PLoS ONE 12(1):e0169907.  https://doi.org/10.1371/journal.pone.0169907 CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Ferreira CR, Orsini MC, Vieira CR et al (2015) Prevalence of anxiety symptoms and depression in the third gestational trimester. Arch Gynecol Obstet 291(5):999–1003.  https://doi.org/10.1007/s00404-014-3508-x CrossRefPubMedGoogle Scholar
  6. 6.
    McHugh RK, Wigderson S, Greenfield SF (2014) Epidemiology of substance use in reproductive-age women. Obstet Gynecol Clin North Am 41(2):177–189.  https://doi.org/10.1016/j.ogc.2014.02.001 CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Maeda A, Bateman BT, Clancy CR et al (2014) Opioid abuse and dependence during pregnancy: temporal trends and obstetrical outcomes. Anesthesiology 121(6):1158–1165.  https://doi.org/10.1097/ALN.0000000000000472 CrossRefPubMedGoogle Scholar
  8. 8.
    Kamyar M, Varner M (2013) Epilepsy in pregnancy. Clin Obstet Gynecol 56(2):330–341.  https://doi.org/10.1097/GRF.0b013e31828f2436 CrossRefPubMedGoogle Scholar
  9. 9.
    Grunwald L, Jorch G, Kropf S et al (2016) The meaning of neurological and psychiatric disease and addiction for pregnancy outcome: a case-control study of the birth cohort 2010–2012. Z Geburtshilfe Neonatol 220(3):116–123.  https://doi.org/10.1055/s-0042-101870 CrossRefPubMedGoogle Scholar
  10. 10.
    Arora A, Patil A (2019) Time to take stock of Indian regulatory guidelines regarding drug use in pregnancy and lactation. Indian J Pharmacol 51(2):126–127.  https://doi.org/10.4103/ijp.IJP_647_18 CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Boden R, Lundgren M, Brandt L et al. (2012) Risks of adverse pregnancy and birth outcomes in women treated or not treated with mood stabilisers for bipolar disorder: population based cohort study. BMJ 345(nov07 6):e7085. 10.1136/bmj.e7085Google Scholar
  12. 12.
    Campbell E, Kennedy F, Russell A et al (2014) Malformation risks of antiepileptic drug monotherapies in pregnancy: updated results from the UK and Ireland Epilepsy and Pregnancy Registers. J Neurol Neurosurg Psychiatry 85(9):1029–1034.  https://doi.org/10.1136/jnnp-2013-306318 CrossRefPubMedGoogle Scholar
  13. 13.
    Rapcencu AE, Lindhout D, Bulk S (2012) Frequently asked questions on epilepsy, pregnancy and lactation: a EURAP-NL report. Seizure 21(8):606–609.  https://doi.org/10.1016/j.seizure.2012.06.011 CrossRefPubMedGoogle Scholar
  14. 14.
    Schaefer C, Oppermann M, Wacker E et al (2012) Drug safety in pregnancy—the Embryotox project (Arzneimitteltherapiesicherheit in der Schwangerschaft—das Embryotox-Projekt). Z Evid Fortbild Qual Gesundhwes 106(10):723–728.  https://doi.org/10.1016/j.zefq.2012.11.012 CrossRefPubMedGoogle Scholar
  15. 15.
    Farmen AH, Grundt J, Tomson T et al (2015) Intrauterine growth retardation in foetuses of women with epilepsy. Seizure.  https://doi.org/10.1016/j.seizure.2015.02.026 CrossRefPubMedGoogle Scholar
  16. 16.
    Bonari L, Pinto N, Ahn E et al (2004) Perinatal risks of untreated depression during pregnancy. Can J Psychiatry 49(11):726–735CrossRefGoogle Scholar
  17. 17.
    Wisner KL, Sit DKY, Hanusa BH et al (2009) Major depression and antidepressant treatment: impact on pregnancy and neonatal outcomes. Am J Psychiatry 166(5):557–566.  https://doi.org/10.1176/appi.ajp.2008.08081170 CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Tettenborn B (2006) Management of epilepsy in women of childbearing age: practical recommendations. CNS Drugs 20(5):373–387CrossRefGoogle Scholar
  19. 19.
    Baer RJ, Chambers CD, Bandoli G et al (2016) Risk of preterm birth by subtype among Medi-Cal participants with mental illness. Am J Obstet Gynecol.  https://doi.org/10.1016/j.ajog.2016.06.017 CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Bakhiet SFA, Essa YAS, Dwieb AMM et al (2017) Correlations between intelligence, head circumference and height: evidence from two samples in Saudi Arabia. J Biosoc Sci 49(2):276–280.  https://doi.org/10.1017/S0021932016000249 CrossRefPubMedGoogle Scholar
  21. 21.
    Neubauer V, Fuchs T, Griesmaier E et al (2016) Poor postdischarge head growth is related to a 10% lower intelligence quotient in very preterm infants at the chronological age of five years. Acta Paediatr 105(5):501–507.  https://doi.org/10.1111/apa.13336 CrossRefPubMedGoogle Scholar
  22. 22.
    DIMDI (2016) DIMDI-ICD-10-GM Version 2017. https://www.dimdi.de/static/de/klassifikationen/icd/icd-10-gm/kode-suche/htmlgm2017/. Accessed 04 Sep 2019
  23. 23.
    Andersson L, Sundström-Poromaa I, Bixo M et al (2003) Point prevalence of psychiatric disorders during the second trimester of pregnancy: a population-based study. Am J Obstet Gynecol 189(1):148–154CrossRefGoogle Scholar
  24. 24.
    Lee AM, Lam SK, Lau SM, Marie S et al (2007) Prevalence, course, and risk factors for antenatal anxiety and depression. Obstet Gynecol 110(5):1102–1112.  https://doi.org/10.1097/01.AOG.0000287065.59491.70 CrossRefPubMedGoogle Scholar
  25. 25.
    Verbeek T, Arjadi R, Vendrik JJ et al (2015) Anxiety and depression during pregnancy in Central America: a cross-sectional study among pregnant women in the developing country Nicaragua. BMC Psychiatry 15(1):292.  https://doi.org/10.1186/s12888-015-0671-y CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Andrade SE, Raebel MA, Brown J et al (2008) Use of antidepressant medications during pregnancy: a multisite study. Am J Obstet Gynecol 198(2):194.e1–5.  https://doi.org/10.1016/j.ajog.2007.07.036 CrossRefGoogle Scholar
  27. 27.
    Ververs T, Kaasenbrood H, Visser G et al (2006) Prevalence and patterns of antidepressant drug use during pregnancy. Eur J Clin Pharmacol 62(10):863–870.  https://doi.org/10.1007/s00228-006-0177-0 CrossRefPubMedGoogle Scholar
  28. 28.
    Charlton RA, Jordan S, Pierini A et al (2015) Selective serotonin reuptake inhibitor prescribing before, during and after pregnancy: a population-based study in six European regions. BJOG 122(7):1010–1020.  https://doi.org/10.1111/1471-0528.13143 CrossRefPubMedGoogle Scholar
  29. 29.
    Artama M, Gissler M, Malm H et al (2013) Effects of maternal epilepsy and antiepileptic drug use during pregnancy on perinatal health in offspring: nationwide, retrospective cohort study in Finland. Drug Saf 36(5):359–369.  https://doi.org/10.1007/s40264-013-0052-8 CrossRefPubMedGoogle Scholar
  30. 30.
    Oluwafemi OR, Njokanma FO, Disu EA et al (2013) Current pattern of Ponderal Indices of term small-for-gestational age in a population of Nigerian babies. BMC Pediatr 13:110.  https://doi.org/10.1186/1471-2431-13-110 CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Garite TJ, Clark R, Thorp JA (2004) Intrauterine growth restriction increases morbidity and mortality among premature neonates. Am J Obstet Gynecol 191(2):481–487.  https://doi.org/10.1016/j.ajog.2004.01.036 CrossRefPubMedGoogle Scholar
  32. 32.
    Sharma D, Shastri S, Sharma P (2016) Intrauterine growth restriction: antenatal and postnatal aspects. Clin Med Insights Pediatr 10:67–83.  https://doi.org/10.4137/CMPed.S40070 CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Guellec I, Lapillonne A, Renolleau S et al (2011) Neurologic outcomes at school age in very preterm infants born with severe or mild growth restriction. Pediatrics 127(4):e883–e891.  https://doi.org/10.1542/peds.2010-2442 CrossRefPubMedGoogle Scholar
  34. 34.
    Morsing E, Asard M, Ley D et al (2011) Cognitive function after intrauterine growth restriction and very preterm birth. Pediatrics 127(4):e874–e882.  https://doi.org/10.1542/peds.2010-1821 CrossRefPubMedGoogle Scholar
  35. 35.
    Saeed A, Raana T, Saeed AM et al (2016) Effect of antenatal depression on maternal dietary intake and neonatal outcome: a prospective cohort. Nutr J 15(1):64.  https://doi.org/10.1186/s12937-016-0184-7 CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Bansil P, Kuklina EV, Meikle SF et al (2010) Maternal and fetal outcomes among women with depression. J Womens Health (Larchmt) 19(2):329–334.  https://doi.org/10.1089/jwh.2009.1387 CrossRefGoogle Scholar
  37. 37.
    Hompoth EA, Pető Z, Fűrészné Balogh V et al. (2019) Associations between depression symptoms, psychological intervention and perinatal complications. J Clin Psychol Med Settings.  https://doi.org/10.1007/s10880-019-09632-4
  38. 38.
    Ciesielski TH, Marsit CJ, Williams SM (2015) Maternal psychiatric disease and epigenetic evidence suggest a common biology for poor fetal growth. BMC Pregnancy Childbirth 15:192.  https://doi.org/10.1186/s12884-015-0627-8 CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Chen D, Hou L, Duan X et al (2017) Effect of epilepsy in pregnancy on fetal growth restriction: a systematic review and meta-analysis. Arch Gynecol Obstet.  https://doi.org/10.1007/s00404-017-4404-y CrossRefPubMedGoogle Scholar
  40. 40.
    Keegan J, Parva M, Finnegan M et al (2010) Addiction in pregnancy. J Addict Dis 29(2):175–191.  https://doi.org/10.1080/10550881003684723 CrossRefPubMedGoogle Scholar
  41. 41.
    Nobles CJ, Grantz KL, Liu D et al (2019) Ambient air pollution and fetal growth restriction: physician diagnosis of fetal growth restriction versus population-based small-for-gestational age. Sci Total Environ 650(Pt 2):2641–2647.  https://doi.org/10.1016/j.scitotenv.2018.09.362 CrossRefPubMedGoogle Scholar
  42. 42.
    Kandall SR, Albin S, Lowinson J et al (1976) Differential effects of maternal heroin and methadone use on birthweight. Pediatrics 58(5):681–685PubMedGoogle Scholar
  43. 43.
    Norgaard M, Nielsson MS, Heide-Jorgensen U (2015) Birth and Neonatal Outcomes Following Opioid Use in Pregnancy: A Danish Population-Based Study. Subst Abuse 9(Suppl 2):5–11.  https://doi.org/10.4137/SART.S23547 CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Bier JB, Finger AS, Bier BA et al (2015) Growth and developmental outcome of infants with in-utero exposure to methadone vs buprenorphine. J Perinatol 35(8):656–659.  https://doi.org/10.1038/jp.2015.22 CrossRefPubMedGoogle Scholar
  45. 45.
    Towers CV, Hyatt BW, Visconti KC et al (2019) Neonatal head circumference in newborns with neonatal abstinence syndrome. Pediatrics 143(1):1.  https://doi.org/10.1542/peds.2018-0541 CrossRefGoogle Scholar
  46. 46.
    de Castro A, Jones HE, Johnson RE et al (2011) Maternal methadone dose, placental methadone concentrations, and neonatal outcomes. Clin Chem 57(3):449–458.  https://doi.org/10.1373/clinchem.2010.154864 CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Hasanjanzadeh P, Faramarzi M (2017) Relationship between maternal general and specific-pregnancy stress, anxiety, and depression symptoms and pregnancy outcome. J Clin Diagn Res 11(4):4–7.  https://doi.org/10.7860/JCDR/2017/24352.9616 CrossRefGoogle Scholar
  48. 48.
    Huang H, Coleman S, Bridge JA et al (2014) A meta-analysis of the relationship between antidepressant use in pregnancy and the risk of preterm birth and low birth weight. Gen Hosp Psychiatry 36(1):13–18.  https://doi.org/10.1016/j.genhosppsych.2013.08.002 CrossRefPubMedGoogle Scholar
  49. 49.
    Lewis AJ, Galbally M, Opie G et al (2010) Neonatal growth outcomes at birth and one month postpartum following in utero exposure to antidepressant medication. Aust N Z J Psychiatry 44(5):482–487.  https://doi.org/10.3109/00048670903559593 CrossRefPubMedGoogle Scholar
  50. 50.
    Veiby G, Daltveit AK, Engelsen BA et al (2009) Pregnancy, delivery, and outcome for the child in maternal epilepsy. Epilepsia 50(9):2130–2139.  https://doi.org/10.1111/j.1528-1167.2009.02147.x CrossRefPubMedGoogle Scholar
  51. 51.
    Hernández-Díaz S, McElrath TF, Pennell PB et al (2017) Fetal growth and premature delivery in pregnant women on antiepileptic drugs. Ann Neurol 82(3):457–465.  https://doi.org/10.1002/ana.25031 CrossRefPubMedGoogle Scholar
  52. 52.
    Liu AJW, Jones MP, Murray H et al (2010) Perinatal risk factors for the neonatal abstinence syndrome in infants born to women on methadone maintenance therapy. Aust N Z J Obstet Gynaecol 50(3):253–258.  https://doi.org/10.1111/j.1479-828X.2010.01168.x CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke-University MagdeburgMagdeburgGermany
  2. 2.Department of Obstetrics and GynaecologyOtto-von-Guericke-University MagdeburgMagdeburgGermany
  3. 3.Department of Gynaecology and ObstetricsPerinatal CentreHalle/SaaleGermany
  4. 4.Institute for Biometry and Medical InformaticsOtto-von-Guericke-University MagdeburgMagdeburgGermany
  5. 5.Department of NeonatologyChongqing Maternal and Child Health HospitalChongqingChina
  6. 6.Department of PaediatricsOtto-von-Guericke-University MagdeburgMagdeburgGermany

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