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).
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