Pregnancy Outcomes in Maternal Neuropsychiatric Illness and Substance Abuse

Abstract

Introduction Worldwide the prevalence of neuropsychiatric illness among women of reproductive age is higher than ever before. This study investigates the influences of maternal substance abuse/dependence and neuropsychiatric illness on pregnancy and neonatal outcomes. Patients and Methods Using a retrospective study design 185 pregnancies in women with neuropsychiatric illnesses or substance abuse were identified at a single centre over a period of 3.25 years and compared to 4907 pregnancies in healthy women without mental illness. Differences in pre-, peri- and postnatal pregnancy parameters were studied. Results Numbers of previous abortions on obstetric history were significantly higher in cases compared to controls, women with depression being especially affected. The number of antenatal visits was also higher among cases, especially in women with depression. The caesarean section rate was significantly higher in cases compared to controls. Children of women with neuropsychiatric illness were born at lower gestational ages than those of healthy control mothers, however there were no significant differences between case and control groups for birth weight, head circumference or Apgar scores. Some isolated differences were found for disease-specific case subgroups compared to controls. Conclusion The study shows a relationship between maternal neuropsychiatric illness and pregnancy outcomes independent of medication use. Rates of spontaneous abortion were higher. Children were born earlier, yet the neonatal outcomes birth weight, head circumference and Apgar score were not worse than children of mentally healthy women.

Escala de Risco de Depressão na Gravidez: elaboração de um modelo teórico

“…A depressão na gravidez está associada a desfechos obstétricos adversos como ameaça de abortamento e pré-eclâmpsia (24)(25).…”

Mindfulness-based Stress Reduction in Pregnancy: an App-Based Programme to Improve the Health of Mothers and Children (MINDFUL/PMI Study)

“…Daneben beeinträchtigen Erkrankungen in der Schwangerschaft auch den Verlauf von Geburt und Wochenbett. Depressive Symptome der Mutter während der Schwangerschaft sind beispielsweise mit einer erhöhten Kaiserschnittrate und einem geringeren Geburtsgewicht assoziiert 60 . Die Entwicklung einer hypertensiven Schwangerschaftserkrankung hat nicht nur akut in der Schwangerschaft Folgen für Mutter und Kind.…”

“…In addition, illnesses during pregnancy also have a negative influence on the course of the delivery and post-delivery period. Depressive symptoms in the mother during pregnancy are associated, for example, with an increased rate of Caesarean sections and low birth weight 60 . The development of a hypertensive disease in pregnancy does not only present acute consequences during pregnancy for the mother and child.…”

Risco de depressão na gravidez entre gestantes inseridas na assistência pré-natal de alto risco

“…Quando ocorre na gravidez, a depressão é denominada pré-natal (4) , e está associada ao bem-estar materno, infantil e familiar adverso (5) . Quando não tratada, a depressão na gravidez repercute em resultados neonatais negativos (6) , desfechos obstétricos adversos (7) , ajustes sociais e pessoais negativos na mãe (8)(9) e predição para a depressão pós-parto (10) .…”