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Journal of perinatology : official journal of the California Perinatal Association
05, 2019;39 (5): 737-745.

Association between maternal serious mental illness and adverse birth outcomes.

H Heun-Johnson, S A Seabury, M Menchine, I Claudius, S Axeen, A Lakshmanan
Author Information
  1. H Heun-Johnson: Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA. heunjohn@usc.edu. ORCID
  2. S A Seabury: Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA.
  3. M Menchine: Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA.
  4. I Claudius: Department of Emergency Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
  5. S Axeen: Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA.
  6. A Lakshmanan: Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA.
PMID: 30850757 DOI: 10.1038/s41372-019-0346-5

Abstract

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.

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Grants

  1. KL2 TR001854/NCATS NIH HHS

MeSH Term

Adult
Cross-Sectional Studies
Databases, Factual
Female
Fetal Distress
Gestational Age
Humans
Infant, Newborn
Length of Stay
Logistic Models
Mental Disorders
Mothers
Multivariate Analysis
Pre-Eclampsia
Pregnancy
Pregnancy Complications
Pregnancy Outcome
Premature Birth
Risk Factors
United States
Journal Article Research Support, N.I.H., Extramural Research Support, U.S. Gov't, Non-P.H.S.
Article has an altmetric score of 11

Word Cloud

Created with Highcharts 10.0.01riskadversebirthoutcomesseriousmentalillnessSMIfactorscomorbiditiessubstanceusematernalrelativefetalwomen06-108increasedOBJECTIVE:evaluatecontributionspecificSTUDYDESIGN:cross-sectionalstudyusesdeliveryrecordsHealthcareCostUtilizationProjectNationwide/NationalInpatientSampleHCUP-NISestimatefactorprevalenceegpreeclampsiapretermdistressRESULTS:gestational1595%CI:13-117obstetric072421-126adjustingsignificantlyreducedremainselevatedthreeoutcomecategoriesgestational:09obstetric:0302-105fetal:1209-114CONCLUSIONS:MaternalindependentlyassociatedHoweverapproximatelyhalfexcessattributableAssociation

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