Maternal and newborn outcomes among women with schizophrenia: a retrospective population‐based cohort study

Objective More women with schizophrenia are becoming pregnant, such that contemporary data are needed about maternal and newborn outcomes in this potentially vulnerable group. We aimed to quantify maternal and newborn health outcomes among women with schizophrenia. Design Retrospective cohort study....

Full description

Saved in:
Bibliographic Details
Published in:BJOG : an international journal of obstetrics and gynaecology 2014-04, Vol.121 (5), p.566-574
Main Authors: Vigod, SN, Kurdyak, PA, Dennis, CL, Gruneir, A, Newman, A, Seeman, MV, Rochon, PA, Anderson, GM, Grigoriadis, S, Ray, JG
Format: Article
Language:English
Subjects:
Abruptio Placentae - epidemiology
Adolescent
Adult
Cesarean Section - statistics & numerical data
Cohort Studies
Diabetes, Gestational - epidemiology
Eclampsia
Female
gestational diabetes
gestational hypertension
Humans
Hypertension, Pregnancy-Induced - epidemiology
Infant Mortality
Infant, Newborn
Infant, Small for Gestational Age
Intensive Care Units - utilization
Labor, Induced - statistics & numerical data
large for gestational age
Maternal Mortality
Middle Aged
Neonatal Abstinence Syndrome - epidemiology
Obstetrics
Ontario - epidemiology
Patient Readmission - statistics & numerical data
Pregnancy
Pregnancy Complications - epidemiology
Premature Birth - epidemiology
preterm birth
pre‐eclampsia
Retrospective Studies
Schizophrenia
Schizophrenia - epidemiology
Shock, Septic - epidemiology
small for gestational age
Venous Thromboembolism - epidemiology
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective More women with schizophrenia are becoming pregnant, such that contemporary data are needed about maternal and newborn outcomes in this potentially vulnerable group. We aimed to quantify maternal and newborn health outcomes among women with schizophrenia. Design Retrospective cohort study. Setting Population based in Ontario, Canada, from 2002 to 2011. Population Ontario women aged 15–49 years who gave birth to a liveborn or stillborn singleton infant. Methods Women with schizophrenia (n = 1391) were identified based on either an inpatient diagnosis or two or more outpatient physician service claims for schizophrenia within 5 years prior to conception. The reference group comprised 432 358 women without diagnosed mental illness within the 5 years preceding conception in the index pregnancy. Main outcome measures The primary maternal outcomes were gestational diabetes mellitus, gestational hypertension, pre‐eclampsia/eclampsia, and venous thromboembolism. The primary neonatal outcomes were preterm birth, and small and large birthweight for gestational age (SGA and LGA). Secondary outcomes included additional key perinatal health indicators. Results Schizophrenia was associated with a higher risk of pre‐eclampsia (adjusted odds ratio, aOR 1.84; 95% confidence interval, 95% CI 1.28–2.66), venous thromboembolism (aOR 1.72, 95% CI 1.04–2.85), preterm birth (aOR 1.75, 95% CI 1.46–2.08), SGA (aOR 1.49, 95% CI 1.19–1.86), and LGA (aOR 1.53, 95% CI 1.17–1.99). Women with schizophrenia also required more intensive hospital resources, including operative delivery and admission to a maternal intensive care unit, paralleled by higher neonatal morbidity. Conclusions Women with schizophrenia are at higher risk of multiple adverse pregnancy outcomes, paralleled by higher neonatal morbidity. Attention should focus on interventions to reduce the identified health disparities.
ISSN:1470-0328
1471-0528
DOI:10.1111/1471-0528.12567