Perinatal outcomes and offspring long-term neuropsychiatric hospitalizations of mothers with anxiety disorder
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ORIGINAL ARTICLE
Perinatal outcomes and offspring long-term neuropsychiatric hospitalizations of mothers with anxiety disorder Levinsky Avraham 1 & Wainstock Tamar 2 & Sheiner Eyal 1 & Pariente Gali 1 Received: 11 April 2019 / Accepted: 7 January 2020 # Springer-Verlag GmbH Austria, part of Springer Nature 2020
Abstract Studies regarding the association between anxiety disorders and obstetrical and neonatal complications are inconclusive and sometimes contradictive. The aim of the present study was to assess perinatal outcome of mothers with anxiety disorder and to determine the association between maternal anxiety and long-term neuropsychiatric hospitalizations of the offspring. A hospitalbased retrospective cohort study was conducted, comparing pregnancy complications and long-term neuropsychiatric hospitalizations of offspring of mothers with anxiety disorder, during or before the pregnancy and mothers without anxiety. All singleton deliveries between the years 1991 and 2014 in a tertiary medical center were included. To evaluate perinatal outcome of women with anxiety disorders, generalized estimation equation (GEE) models were used to control for confounders. A Kaplan-Meier survival curve was used to compare cumulative incidence of long-term neuropsychiatric hospitalizations, and a Cox proportional hazards model was constructed to control for confounders. During the study period, 242,038 deliveries met the inclusion criteria, of them 0.1% (n = 304) were mothers with anxiety. Using GEE models, controlling for maternal age, maternal anxiety was noted as an independent risk factor for preterm delivery (adjusted OR 1.8, 95% CI 1.32–2.69; P < 0.001), hypertensive disorders (adjusted OR 1.7, 95% CI 1.08–2.69; P = 0.02) and cesarean delivery (adjusted OR 1.6, 95% CI 1.32–2.1; P < 0.001). Offspring born to mothers with anxiety disorders had higher rates of neuropsychiatric-related hospitalizations (6.3 vs 3.1% P = 0.002; Kaplan-Meier log-rank test P < 0.001). Using a Cox proportional hazards model, controlling for confounders such as maternal age, hypertensive disorders, gestational age, birth weight, and cesarean delivery, being born to a mother with anxiety disorders was found to be an independent risk factor for long-term neuropsychiatric hospitalizations of the offspring (adjusted HR 2.4, 95% CI 1.58–3.89; P < 0.001). Pregnancy of women with anxiety disorders is independently associated with adverse perinatal outcome and higher risk for long-term neuropsychiatric hospitalizations of the offspring. Keywords Maternal . Anxiety . Long term offspring
Background Anxiety disorders, defined according to DSM-V diagnostic criteria, include panic disorder, agoraphobia, obsessiveLevinsky Avraham and Wainstock Tamar contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00737-020-01018-y) contains supplementary material, which is available to authorized users. * Pariente Gali [email protected] 1
Department of Obstetrics and Gynecology, Soroka Univers
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