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Risk of stillbirth and neonatal death linked with maternal mental illness: a national cohort study.
Arch Dis Child Fetal Neonatal Ed. 2009 Mar; 94(2):F105-10.AD

Abstract

BACKGROUND

Babies of mothers with psychotic disorders are known to have higher rates of poor obstetric outcome, including higher mortality rates.

OBJECTIVE

To estimate risks of stillbirth and neonatal death by specific causes in babies of mothers with histories of severe mental illness, relative to the general population.

METHODS

A cohort of 1.45 million live births and 7021 stillbirths during 1973-98 was identified from Danish national registers. These registers were linked to identify babies who were stillborn or died neonatally after exposure to maternal psychiatric illness.

RESULTS

Risks of stillbirth and neonatal death were raised for virtually all causes of death for all of the maternal psychiatric diagnostic categories. For most causes of death, offspring of women with schizophrenia and related disorders had no greater risks of stillbirth or neonatal death than offspring of women with other maternal psychiatric disorders (eg, neonatal death (NND) due to immaturity: relative risks (95% CI) schizophrenia and related disorders: 1.1 (0.4 to 3.5), affective disorders: 2.0 (1.2 to 3.5)). There was a greater risk of fatal congenital malformation associated with a history of maternal affective disorder (stillbirth 2.4 (1.1 to 5.1), NND 2.1 (1.4 to 3.3)) or schizophrenia and related disorders (stillbirth 2.4 (0.8 to 7.6), NND 2.2 (1.1 to 4.1)) than with maternal alcohol/drug-related disorders (stillbirth 1.2 (0.4 to 3.8), NND 1.1 (0.6 to 2.2)).

CONCLUSIONS

Higher risk of perinatal loss may be linked to factors associated with maternal psychiatric illness in general, such as insufficient attendance for antenatal care and unhealthy lifestyles rather than the maternal mental illness itself.

Authors+Show Affiliations

Centre for Women's Mental Health, University of Manchester, University Place, Oxford Road, Manchester, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19000999

Citation

King-Hele, S, et al. "Risk of Stillbirth and Neonatal Death Linked With Maternal Mental Illness: a National Cohort Study." Archives of Disease in Childhood. Fetal and Neonatal Edition, vol. 94, no. 2, 2009, pp. F105-10.
King-Hele S, Webb RT, Mortensen PB, et al. Risk of stillbirth and neonatal death linked with maternal mental illness: a national cohort study. Arch Dis Child Fetal Neonatal Ed. 2009;94(2):F105-10.
King-Hele, S., Webb, R. T., Mortensen, P. B., Appleby, L., Pickles, A., & Abel, K. M. (2009). Risk of stillbirth and neonatal death linked with maternal mental illness: a national cohort study. Archives of Disease in Childhood. Fetal and Neonatal Edition, 94(2), F105-10. https://doi.org/10.1136/adc.2007.135459
King-Hele S, et al. Risk of Stillbirth and Neonatal Death Linked With Maternal Mental Illness: a National Cohort Study. Arch Dis Child Fetal Neonatal Ed. 2009;94(2):F105-10. PubMed PMID: 19000999.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of stillbirth and neonatal death linked with maternal mental illness: a national cohort study. AU - King-Hele,S, AU - Webb,R T, AU - Mortensen,P B, AU - Appleby,L, AU - Pickles,A, AU - Abel,K M, Y1 - 2008/11/10/ PY - 2008/11/13/pubmed PY - 2009/3/21/medline PY - 2008/11/13/entrez SP - F105 EP - 10 JF - Archives of disease in childhood. Fetal and neonatal edition JO - Arch. Dis. Child. Fetal Neonatal Ed. VL - 94 IS - 2 N2 - BACKGROUND: Babies of mothers with psychotic disorders are known to have higher rates of poor obstetric outcome, including higher mortality rates. OBJECTIVE: To estimate risks of stillbirth and neonatal death by specific causes in babies of mothers with histories of severe mental illness, relative to the general population. METHODS: A cohort of 1.45 million live births and 7021 stillbirths during 1973-98 was identified from Danish national registers. These registers were linked to identify babies who were stillborn or died neonatally after exposure to maternal psychiatric illness. RESULTS: Risks of stillbirth and neonatal death were raised for virtually all causes of death for all of the maternal psychiatric diagnostic categories. For most causes of death, offspring of women with schizophrenia and related disorders had no greater risks of stillbirth or neonatal death than offspring of women with other maternal psychiatric disorders (eg, neonatal death (NND) due to immaturity: relative risks (95% CI) schizophrenia and related disorders: 1.1 (0.4 to 3.5), affective disorders: 2.0 (1.2 to 3.5)). There was a greater risk of fatal congenital malformation associated with a history of maternal affective disorder (stillbirth 2.4 (1.1 to 5.1), NND 2.1 (1.4 to 3.3)) or schizophrenia and related disorders (stillbirth 2.4 (0.8 to 7.6), NND 2.2 (1.1 to 4.1)) than with maternal alcohol/drug-related disorders (stillbirth 1.2 (0.4 to 3.8), NND 1.1 (0.6 to 2.2)). CONCLUSIONS: Higher risk of perinatal loss may be linked to factors associated with maternal psychiatric illness in general, such as insufficient attendance for antenatal care and unhealthy lifestyles rather than the maternal mental illness itself. SN - 1468-2052 UR - https://www.unboundmedicine.com/medline/citation/19000999/Risk_of_stillbirth_and_neonatal_death_linked_with_maternal_mental_illness:_a_national_cohort_study_ L2 - http://fn.bmj.com/cgi/pmidlookup?view=long&pmid=19000999 DB - PRIME DP - Unbound Medicine ER -