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Maternal and newborn outcomes among women with schizophrenia: a retrospective population-based cohort study.
BJOG. 2014 Apr; 121(5):566-74.BJOG

Abstract

OBJECTIVE

More women with schizophrenia are becoming pregnant, such that contemporary data are needed about maternal and newborn outcomes in this potentially vulnerable group. We aimed to quantify maternal and newborn health outcomes among women with schizophrenia.

DESIGN

Retrospective cohort study.

SETTING

Population based in Ontario, Canada, from 2002 to 2011.

POPULATION

Ontario women aged 15-49 years who gave birth to a liveborn or stillborn singleton infant.

METHODS

Women with schizophrenia (n = 1391) were identified based on either an inpatient diagnosis or two or more outpatient physician service claims for schizophrenia within 5 years prior to conception. The reference group comprised 432 358 women without diagnosed mental illness within the 5 years preceding conception in the index pregnancy.

MAIN OUTCOME MEASURES

The primary maternal outcomes were gestational diabetes mellitus, gestational hypertension, pre-eclampsia/eclampsia, and venous thromboembolism. The primary neonatal outcomes were preterm birth, and small and large birthweight for gestational age (SGA and LGA). Secondary outcomes included additional key perinatal health indicators.

RESULTS

Schizophrenia was associated with a higher risk of pre-eclampsia (adjusted odds ratio, aOR 1.84; 95% confidence interval, 95% CI 1.28-2.66), venous thromboembolism (aOR 1.72, 95% CI 1.04-2.85), preterm birth (aOR 1.75, 95% CI 1.46-2.08), SGA (aOR 1.49, 95% CI 1.19-1.86), and LGA (aOR 1.53, 95% CI 1.17-1.99). Women with schizophrenia also required more intensive hospital resources, including operative delivery and admission to a maternal intensive care unit, paralleled by higher neonatal morbidity.

CONCLUSIONS

Women with schizophrenia are at higher risk of multiple adverse pregnancy outcomes, paralleled by higher neonatal morbidity. Attention should focus on interventions to reduce the identified health disparities.

Authors+Show Affiliations

Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Women's College Research Institute, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical and Evaluative Sciences, Toronto, Ontario, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

24443970

Citation

Vigod, S N., et al. "Maternal and Newborn Outcomes Among Women With Schizophrenia: a Retrospective Population-based Cohort Study." BJOG : an International Journal of Obstetrics and Gynaecology, vol. 121, no. 5, 2014, pp. 566-74.
Vigod SN, Kurdyak PA, Dennis CL, et al. Maternal and newborn outcomes among women with schizophrenia: a retrospective population-based cohort study. BJOG. 2014;121(5):566-74.
Vigod, S. N., Kurdyak, P. A., Dennis, C. L., Gruneir, A., Newman, A., Seeman, M. V., Rochon, P. A., Anderson, G. M., Grigoriadis, S., & Ray, J. G. (2014). Maternal and newborn outcomes among women with schizophrenia: a retrospective population-based cohort study. BJOG : an International Journal of Obstetrics and Gynaecology, 121(5), 566-74. https://doi.org/10.1111/1471-0528.12567
Vigod SN, et al. Maternal and Newborn Outcomes Among Women With Schizophrenia: a Retrospective Population-based Cohort Study. BJOG. 2014;121(5):566-74. PubMed PMID: 24443970.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Maternal and newborn outcomes among women with schizophrenia: a retrospective population-based cohort study. AU - Vigod,S N, AU - Kurdyak,P A, AU - Dennis,C L, AU - Gruneir,A, AU - Newman,A, AU - Seeman,M V, AU - Rochon,P A, AU - Anderson,G M, AU - Grigoriadis,S, AU - Ray,J G, Y1 - 2014/01/21/ PY - 2013/10/16/accepted PY - 2014/1/22/entrez PY - 2014/1/22/pubmed PY - 2014/5/23/medline KW - Eclampsia KW - gestational diabetes KW - gestational hypertension KW - large for gestational age KW - pre-eclampsia KW - pregnancy KW - preterm birth KW - schizophrenia KW - small for gestational age SP - 566 EP - 74 JF - BJOG : an international journal of obstetrics and gynaecology JO - BJOG VL - 121 IS - 5 N2 - OBJECTIVE: More women with schizophrenia are becoming pregnant, such that contemporary data are needed about maternal and newborn outcomes in this potentially vulnerable group. We aimed to quantify maternal and newborn health outcomes among women with schizophrenia. DESIGN: Retrospective cohort study. SETTING: Population based in Ontario, Canada, from 2002 to 2011. POPULATION: Ontario women aged 15-49 years who gave birth to a liveborn or stillborn singleton infant. METHODS: Women with schizophrenia (n = 1391) were identified based on either an inpatient diagnosis or two or more outpatient physician service claims for schizophrenia within 5 years prior to conception. The reference group comprised 432 358 women without diagnosed mental illness within the 5 years preceding conception in the index pregnancy. MAIN OUTCOME MEASURES: The primary maternal outcomes were gestational diabetes mellitus, gestational hypertension, pre-eclampsia/eclampsia, and venous thromboembolism. The primary neonatal outcomes were preterm birth, and small and large birthweight for gestational age (SGA and LGA). Secondary outcomes included additional key perinatal health indicators. RESULTS: Schizophrenia was associated with a higher risk of pre-eclampsia (adjusted odds ratio, aOR 1.84; 95% confidence interval, 95% CI 1.28-2.66), venous thromboembolism (aOR 1.72, 95% CI 1.04-2.85), preterm birth (aOR 1.75, 95% CI 1.46-2.08), SGA (aOR 1.49, 95% CI 1.19-1.86), and LGA (aOR 1.53, 95% CI 1.17-1.99). Women with schizophrenia also required more intensive hospital resources, including operative delivery and admission to a maternal intensive care unit, paralleled by higher neonatal morbidity. CONCLUSIONS: Women with schizophrenia are at higher risk of multiple adverse pregnancy outcomes, paralleled by higher neonatal morbidity. Attention should focus on interventions to reduce the identified health disparities. SN - 1471-0528 UR - https://www.unboundmedicine.com/medline/citation/24443970/Maternal_and_newborn_outcomes_among_women_with_schizophrenia:_a_retrospective_population_based_cohort_study_ L2 - https://doi.org/10.1111/1471-0528.12567 DB - PRIME DP - Unbound Medicine ER -