Impact of a prenatal episode and diagnosis in women with serious mental illnesses on neonatal complications (prematurity, low birth weight, and hospitalization in neonatal intensive care units)
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Pregnancy in women with mental disorders is increasingly common. The aim of this study was to determine, in women with severe mental illnesses, whether a prenatal episode was related to neonatal complications and if a specific disorder was associated with a higher risk. A population of infants and their mothers (n = 1439) jointly admitted to psychiatric Mother-Baby Units in France and Belgium (2001–2010) was assessed respectively for prematurity, low birth weight (LBW), hospitalization in neonatal intensive care units (NICUs), and maternal mental health during pregnancy. Logistic regression was used to explore the association between neonatal complications and a prenatal episode of mental illness and if the presence of a specific disorder was related to a higher risk, taking into account maternal socio-demographic characteristics, pregnancy data, and antenatal exposure to psychotropic drugs. Among the children, 145 (10.2%) were premature, 226 (15.8%) had a LBW, and 348 (24.3%) have been hospitalized in neonatology. The presence of an episode of mental illness during pregnancy was linked to LBW (OR = 2.21 [1.44–3.38]; p = 0.003) and NICU hospitalizations (OR = 1.53 [1.06–2.19], p = 0.002). Among diagnoses, the presence of a severe substance use disorder in these women was related to LBW (OR = 2.96 [1.49–5.85]; p = 0.002) and NICU (OR = 2.88 [1.56–5.29]; p = 0.04). Our results underline the importance of systematic and early detection of psychiatric symptoms and substance use disorders during pregnancy in preventing neonatal complications in women with serious mental illness.
KeywordsLow birth weight NICU hospitalization Pregnancy Prematurity Psychiatric disorder Substance use disorder
The authors thank the members of MBUs: Bordeaux, Montesson, Strasbourg, Le Vesinet, Créteil, Villejuif, Paris, Brussels, Limoges, Ottiginies, Marseille, Gent, Lille, Besançon, Albi, and Brumath who contributed to data collection, and the women who participated in the study.
The study received financial support from the Francophone Marcé Society.
Compliance with ethical standards
All selected women provided informed consent for their inclusion in the database. The study was performed in accordance with the ethics standards of the French National Data Protection Authority (CNIL) which the CNIL approved the study.
Conflicts of interest
Regarding potential conflicts of interest, all of them were indirect:
Reda Boukakiou, Nine Glangeaud-Feudenthal, and Anne-Laure Sutter-Dallay report no financial relationships with commercial interests.
Bruno Falissard has been a consultant, expert, or has given talks for E. Lilly, BMS, Servier, Sanofi, GlaxoSmithKline, HRA, Roche, Boeringer Ingelheim, Bayer, Almirall, Allergan, Stallergene, Genzyme, Pierre Fabre, Astra Zeneca, Novartis, Janssen, Astellas, Biotronik, Daiichi-Sankyo, Gilead, MSD, and Lundbeck. Florence Gressier has given talks for Lundbeck and Servier and received a grant from Servier for a postdoctoral degree (2011–2012).
- Combier E, Gouyon JB, Roussot A, Cottenet J, Quantin C (2014) Increased morbidity and mortality of children born at 35-38 weeks of gestation in metropolitan France. Bull Epidemiol Hebd 34-35:558–566Google Scholar
- Ferraguti G, Ciolli P, Carito V, Battagliese G, Mancinelli R, Ciafrè S, Tirassa P, Ciccarelli R, Cipriani A, Messina MP, Fiore M, Ceccanti M (2017) Ethylglucuronide in the urine as a marker of alcohol consumption during pregnancy: comparison with four alcohol screening questionnaires. Toxicol Lett 275:49–56CrossRefGoogle Scholar
- Lee SW, Han YJ, Cho DH, Kwak HS, Ko K, Park MH, Han JY (2018) Smoking exposure in early pregnancy and adverse pregnancy outcomes: usefulness of urinary tobacco-specific nitrosamine metabolite 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol levels. Gynecol Obstet Investig 83:365–374CrossRefGoogle Scholar
- Salmon MP, Appleby A (2000) Predictors of clinical outcome, other outcomes and risk of harm to babies using data from the national audit of mother and baby admissions to psychiatric hospitals. Arch Womens Ment Health 3:107Google Scholar
- Sentilhes L, Sénat MV, Ancel PY, Azria E, Benoist G, Blanc J, Brabant G, Bretelle F, Brun S, Doret M, Ducroux-Schouwey C, Evrard A, Kayem G, Maisonneuve E, Marcellin L, Marret S, Mottet N, Paysant S, Riethmuller D, Rozenberg P, Schmitz T, Torchin H, Langer B (2017) Prevention of spontaneous preterm birth: Guidelines for clinical practice from the French College of Gynaecologists and Obstetricians (CNGOF). Eur J Obstet Gynecol Reprod Biol 210:217–224CrossRefGoogle Scholar
- Sutter-Dallay AL, Bales M, Pambrun E, Nine MC, Wisner KL, Verdoux H (2015) Impact of prenatal exposure to psychotropic drugs on neonatal outcome in infants of mothers with serious psychiatric illnesses. J Clin Psychol 76:967–973Google Scholar
- The World Health Report (2005) 2005 : Make every mother and child count. World Health Organization, GenevaGoogle Scholar
- Thibaut F, Chagraoui A, Buckley L, Gressier F, Labad J, Lamy S, Potenza MN, Marta Rondon M, Rossler A, Mickael Soyka M, Yonkers K (2018) WSBP and IAWMH guidelines for the treatment of alcohol use disorders in pregnant women. World J Biol Psychiatry. https://doi.org/10.1080/15622975.2018.1510185
- Walhovd KB, Fjell AM, Brown TT, Kuperman JM, Chung Y, Hagler DJ Jr, Roddey JC, Erhart M, McCabe C, Akshoomoff N, Amaral DG, Bloss CS, Libiger O, Schork NJ, Darst BF, Casey BJ, Chang L, Ernst TM, Frazier J, Gruen JR, Kaufmann WE, Murray SS, van Zijl P, Mostofsky S, Dale AM, for the Pediatric Imaging, Neurocognition, and Genetics Study, Jernigan TL, McCabe C, Chang L, Akshoomoff N, Newman E, Dale AM, Ernst T, Dale AM, van Zijl P, Kuperman J, Murray S, Bloss C, Schork NJ, Appelbaum M, Gamst A, Thompson W, Bartsch H, Jernigan TL, Dale AM, Akshoomoff N, Chang L, Ernst T, Keating B, Amaral D, Sowell E, Kaufmann W, van Zijl P, Mostofsky S, Casey BJ, Ruberry EJ, Powers A, Rosen B, Kenet T, Frazier J, Kennedy D, Gruen J (2012) Long-term influence of normal variation in neonatal characteristics on human brain development. Proc Natl Acad Sci U S A 109:20089–20094CrossRefGoogle Scholar