Association between maternal serious mental illness and adverse birth outcomes

被引:27
|
作者
Heun-Johnson, H. [1 ,2 ]
Seabury, S. A. [1 ,3 ]
Menchine, M. [1 ,4 ]
Claudius, I [5 ]
Axeen, S. [1 ,4 ]
Lakshmanan, A. [1 ,6 ,7 ]
机构
[1] Univ Southern Calif, Leonard D Schaeffer Ctr Hlth Policy & Econ, Los Angeles, CA 90007 USA
[2] Univ Southern Calif, Sol Price Sch Publ Policy, Los Angeles, CA 90007 USA
[3] Univ Southern Calif, Sch Pharm, Dept Pharmaceut & Hlth Econ, Los Angeles, CA USA
[4] Univ Southern Calif, Keck Sch Med, Dept Emergency Med, Los Angeles, CA USA
[5] Univ Calif Los Angeles, David Geffen Sch Med, Dept Emergency Med, Los Angeles, CA 90095 USA
[6] Univ Southern Calif, Keck Sch Med, Dept Prevent Med, Los Angeles, CA USA
[7] Univ Southern Calif, Childrens Hosp Los Angeles, Keck Sch Med, Fetal & Neonatal Inst,Div Neonatol,Dept Pediat, Los Angeles, CA USA
关键词
LONG-TERM CONSEQUENCES; PREGNANT-WOMEN; PSYCHIATRIC-DISORDERS; MOOD STABILIZERS; BIPOLAR DISORDER; PRETERM BIRTH; RISK; FETAL; SCHIZOPHRENIA; COMORBIDITY;
D O I
10.1038/s41372-019-0346-5
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective To evaluate the contribution of serious mental illness (SMI) and specific risk factors (comorbidities and substance use) to the risk of adverse birth outcomes. Study design This cross-sectional study uses maternal delivery records in the Healthcare Cost and Utilization Project Nationwide/National Inpatient Sample (HCUP-NIS) to estimate risk factor prevalence and relative risk of adverse birth outcomes (e.g., preeclampsia, preterm birth, and fetal distress) in women with SMI. Results The relative risk of adverse gestational (1.15, 95% CI: 1.13-1.17), obstetric (1.07, 1.06-1.08), and fetal (1.24, 1.21-1.26) outcomes is increased for women with SMI. After adjusting for risk factors, the risk is significantly reduced but remains elevated for all three adverse outcome categories (gestational: 1.08, 1.06-1.09; obstetric: 1.03, 1.02-1.05; fetal: 1.12, 1.09-1.14). Conclusions Maternal serious mental illness is independently associated with increased risk for adverse birth outcomes. However, approximately half of the excess risk is attributable to comorbidities and substance use.
引用
收藏
页码:737 / 745
页数:9
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