Effect of depressive disorders and other psychiatric disorders on pregnancy and perinatal outcomes in a Hong Kong obstetrics unit

Abstract

Objectives: To determine the prevalence of psychiatric disorders in Chinese pregnant women in Hong Kong, the effect of psychiatric disorders on pregnancy and perinatal outcomes, and the effect of antidepressants on pregnancy and perinatal outcomes. Methods: We retrospectively reviewed medical records of women who delivered in Tuen Mun Hospital after 24 weeks of gestation between 1 January 2016 and 31 December 2017. Chinese pregnant women with psychiatric disorders were identified. Women with multiple pregnancy were excluded. Results: Of 9049 Chinese pregnant women included, 216 (2.4%) reported psychiatric disorders, with depressive disorders being the most prevalent (1%). Compared to pregnant women with no psychiatric disorders, pregnant women with psychiatric disorders were more likely to have gestational diabetes (10.2% vs 5.7%, p=0.005) and/ or pre-existing diabetes (4.2% vs 1.9%, p=0.018) and preterm births before 37 weeks (13.9% vs 7.5%, p=0.001). Similarly, women with depressive disorders were more likely to have gestational diabetes (11.4% vs 5.7%, p=0.022) and preterm birth before 37 weeks (13.6% vs 7.5%, p=0.031). In multiple logistic regression, pregnant women with psychiatric disorders or depressive disorders were associated with nearly twofold increase in the risks of gestational diabetes mellitus and preterm birth before 37 weeks, after adjusting for cofounding factors. Conclusion: Depression and psychiatric disorders were associated with preterm birth and gestational diabetes. Use of antidepressants had no adverse effect on maternal or fetal outcomes.