Pre-existing mental health disorders affect pregnancy and neonatal outcomes: a retrospective cohort study
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RESEARCH ARTICLE
Open Access
Pre-existingmental health disorders affect pregnancy and neonatal outcomes: a retrospectivecohort study Kotryna Sūdžiūtė1*, Greta Murauskienė1, Kristina Jarienė2, Algirdas Jaras1, Meilė Minkauskienė2, Virginija Adomaitienė1 and Irena Nedzelskienė3
Abstract Background: 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. Methods: A 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. Results: Pregnant 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. Conclusions: Women 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). Keywords: pregnancy, mental disorders, antenatal care, delivery outcomes, neonatal outcomes
Background Mental disorders are among the most common conditions affecting women of reproductive age. 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]. * Correspondence: [email protected] 1 Faculty of medicine, Clinic of Psychiatry, Lithuanian University of Health Sciences, Medical Academy, Eivenių street 2, LT-50161 Kaunas, Lithuania Full list of author information is available at the end of the article
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
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