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Psychiatric Briefs

Prim Care Companion J Clin Psychiatry 2009;11(1):41
Objective: 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.