Purpose
To study the effect of maternal psychiatric disorders (depression, anxiety disorder, bipolar disease, schizophrenia, unspecified psychiatric disorder, and comorbid conditions) and odds of preterm birth.
Methods
The Consortium on Safe Labor (2002-2008), an observational cohort with 12 centers from across the U.S. included 223,394 singleton pregnancies with clinical data obtained from electronic medical records and maternal diagnoses of psychiatric disorders from maternal discharge summaries. Length of gestation was based on the best clinical estimate and categorized as birth <39, <37, <34 and <28 weeks’ gestation. The adjusted odds ratios (ORs) with 95% confidence intervals of birth were estimated by logistic regression with generalized estimating equations.
Results
Any maternal psychiatric disorder was associated with odds of birth <39 weeks’ gestation (OR=1.32, 95% confidence interval 1.28-1.37), <37 weeks’ gestation (OR=1.45, 1.38-1.52), <34 weeks’ gestation (OR=1.47, 1.35-1.59) and <28 weeks’ gestation (OR=1.57, 1.36-1.82). Specifically, odds of birth <37 weeks’ gestation were associated with maternal depression (OR=1.31, 1.23-1.40), anxiety disorder (OR=1.68, 1.41-2.01), depression with anxiety disorder (OR=2.31, 1.93-2.78), bipolar disease (OR=1.54, 1.22-1.94), bipolar disease with depression and=or anxiety disorder (OR=1.70, 1.30-2.22) and unspecified psychiatric disorder (OR=1.52, 1.41-1.64).
Conclusions
Maternal psychiatric disorders, especially comorbid psychiatric conditions, were associated with increased likelihood of preterm birth.