Schizophrenia Associated With More Pregnancy, Neonatal Complications

Women with schizophrenia had more pregnancy, delivery, and neonatal complications compared with matched controls without a severe mental disorder, according to a national population-based study published in The Lancet Regional Health – Europe.

“Our results highlight the importance of health inequalities between pregnant women with and without schizophrenia as well as in their newborns,” researchers wrote.

The study looked at a variety of outcomes for more than 3.5 million singleton deliveries in France between 2015 and 2019. Among them, 3108 involved women with schizophrenia.

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On the whole, women with schizophrenia were older, with higher rates of addiction, obesity, diabetes, and chronic obstructive pulmonary disease than women without mental disorders.

When researchers matched women with schizophrenia 1:4 with controls inside the same hospital and the same year by age, social deprivation, parity, smoking, alcohol and substance addictions, malnutrition, obesity, and comorbidities, they found women with schizophrenia had higher rates of the following pregnancy complications: gestational diabetes (the study reported a 1.38 adjusted odds ratio [aOR]), gestational hypertension (1.42 aOR), genitourinary infection (1.36 aOR), intrauterine growth retardation (1.37 aOR), and threatened preterm labor (1.52 aOR).

Matched analyses also revealed more delivery complications, particularly more still births/medical abortions (2.17 aOR) and caesarean sections (1.15 aOR), among women with schizophrenia. Compared with controls, newborns of women with schizophrenia, meanwhile, had more neonatal complications: preterm births (1.64 aOR), small for gestational age (1.34 aOR), and low birth weight (1.75 aOR).

Fewer than a third of women with schizophrenia had regular contact with psychiatric care during pregnancy.

“These results suggest unmet needs in mental illness control, addictions, and physical comorbidities in preconceptional care that could improve the outcomes of pregnancy,” researchers wrote.

Reference

Fabre C, Pauly V, Baumstarck K, et al. Pregnancy, delivery and neonatal complications in women with schizophrenia: a national population-based cohort study. The Lancet Regional Health – Europe. Published online September 6, 2021. doi: 10.1016/j.lanepe.2021.100209