Pregnancy Outcome of Patients with Schizophrenia

ABSTRACT

We sought to identify whether schizophrenia during pregnancy is associated with adverse perinatal outcomes. A population-based study comparing women with and without schizophrenia and schizoaffective disorders was performed. Stratified analysis using multiple logistic regression models was performed to control for confounders. During the study period, there were 186,554 deliveries, of which 97 occurred in patients with schizophrenia and schizoaffective disorders. The schizophrenic patients were significantly older (mean age 30.6 versus 28.6, p = 0.001), with higher prevalence of diabetes mellitus as compared with the comparison group (13.4% versus 6.7%, p = 0.009). The need for induction and augmentation of delivery, congenital malformations, and low birth weight (<2500 g) were significantly increased among schizophrenic patients. No significant differences were noted between the groups regarding labor complications such as cesarean delivery (16.5% versus 13.2%, p = 0.337) and placenta previa and placental abruption (1% versus 4%, p = 0.333 and 1% versus 0.7%, p = 0.51, respectively). Using a multivariable logistic regression model, schizophrenia and schizoaffective disorders during pregnancy were independent risk factors for congenital malformations (odds ratio 2.1; 95% confidence interval, 1.1 to 3.9, p = 0.027). Schizophrenia and schizoaffective disorders are independent risk factors for congenital malformations.

KEYWORDS

Schizophrenia - schizoaffective disorders - congenital malformations - pregnancy outcome

REFERENCES

• 1 Bennedsen B E. Adverse pregnancy outcome in schizophrenic women: occurrence and risk factors.  Schizophr Res. 1998;  33 1-26
• 2 Howard L M, Goss C, Leese M, Thornicroft G. Medical outcome of pregnancy in women with psychotic disorders and their infants in the first year after birth.  Br J Psychiatry. 2003;  182 63-67
• 3 Nilsson E, Lichtenstein P, Cnattingius S, Murray R M, Hultman C M. Women with schizophrenia: pregnancy outcome and infant death among their offspring.  Schizophr Res. 2002;  58 221-229
• 4 Webb R, Abel K, Pickles A, Appleby L. Mortality in offspring of parents with psychotic disorders: a critical review and meta-analysis.  Am J Psychiatry. 2005;  162 1045-1056
• 5 Jablensky A V, Morgan V, Zubrick S R, Bower C, Yellachich L A. Pregnancy, delivery, and neonatal complications in a population cohort of women with schizophrenia and major affective disorders.  Am J Psychiatry. 2005;  162 79-91
• 6 Bennedsen B E, Mortensen P B, Olesen A V, Henriksen T B. Congenital malformations, stillbirths, and infant deaths among children of women with schizophrenia.  Arch Gen Psychiatry. 2001;  58 674-679
• 7 Schneid-Kofman N, Sheiner E, Levy A. Psychiatric illness and adverse pregnancy outcome.  Int J Gynaecol Obstet. 2008;  101 53-56
• 8 Bennedsen B E, Mortensen P B, Olesen A V, Henriksen T B. Preterm birth and intra-uterine growth retardation among children of women with schizophrenia.  Br J Psychiatry. 1999;  175 239-245
• 9 Howard L M. Fertility and pregnancy in women with psychotic disorders.  Eur J Obstet Gynecol Reprod Biol. 2005;  119 3-10
• 10 Trixler M, Gáti A, Fekete S, Tényi T. Use of antipsychotics in the management of schizophrenia during pregnancy.  Drugs. 2005;  65 1193-1206
• 11 Sheiner E, Levy A, Hershkovitz R et al.. Determining factors associated with shoulder dystocia: a population-based study.  Eur J Obstet Gynecol Reprod Biol. 2006;  126 11-15