Prim Care Companion J Clin Psychiatry 2009;11(1):41
© Copyright 2015 Physicians Postgraduate Press, Inc.
To identify the adverse effect of psychiatric illness during pregnancy
on pregnancy outcome.
Method: In this large population-based study of deliveries (1988–2005),
women with and without psychiatric illness were compared. Stratified analysis
included multiple logistic regression models.
Results: In 607 (0.3%) of 181,479 deliveries, women endorsed psychiatric
illness: depressive and anxiety disorders (39%), schizophrenia (11%), or other
psychiatric illness (50%). The psychiatric patients had higher prevalence of
diabetes and hypertensive disorders and were significantly older than women
without psychiatric illness. In addition, perinatal mortality rate, congenital malformations,
low Apgar scores, and low birth weight (< 2500 g) were significantly
higher in women with psychiatric illness than in those without. That
psychiatric illness during pregnancy is an independent risk factor for perinatal
mortality (odds ratio [OR] = 2.4; 95% CI = 1.5 to 3.7, p < .001) and congenital
malformations (OR = 1.4; 95% CI = 1.01 to 1.9, p = .03) was determined by
multivariable logistic regression models.
Conclusions: Providers of prenatal care should be vigilant for the presence
of psychiatric illness in pregnant women, as such illness is an independent risk
factor for congenital malformations and perinatal mortality.