Effect of maternal obsessive‐compulsive disorder (OCD) on feto‐maternal outcomes: A systematic review and meta‐analysis

Abstract

BackgroundMental health disorders in pregnant women have been related to unfavorable obstetric and neonatal outcomes. Obsessive‐compulsive disorder (OCD) significantly distresses mothers and affects the maternal–infant bond.ObjectivesThe present meta‐analysis and systematic review aimed to assess the association of maternal OCD with adverse feto‐maternal outcomes.Search StrategyA systematic search was undertaken in the five databases—Cochrane, Embase, ProQuest, Web of Science, and PubMed—on September 5, 2023.Selection CriteriaStudies that included pregnant women with OCD in whom the feto‐maternal outcomes were reported were included in the systematic review.Data Collection and AnalysisTwo pass screening (“title‐abstract screening” followed by “full‐text review”), and data extraction by two authors independently using the Nested‐Knowledge Auto living semi‐automated systematic review platform was carried out. The decision for selected studies was reviewed by a third author. Of the 360 studies identified, eight were included for the meta‐analysis. Meta‐analysis was conducted using R software.Main ResultsOf the 24 maternal and neonatal adverse outcomes assessed, 11 were found to be associated with maternal OCD, notably pre‐eclampsia (odds ratio [OR] 1.37, 95% confidence interval [CI] 1.19–1.57), antepartum hemorrhage or placental abruption (OR 1.32, 95% CI 1.13–1.54), postpartum hemporrhage (OR 1.19, 95% CI 1.08–1.31), cesarean section delivery (OR 1.32, 95% CI 1.23–1.41), emergency cesarean section (OR 1.22, 95% CI 1.15–1.30), preterm birth (OR 1.41, 95% CI 1.21–1.64), low birth weight (OR 1.41, 95% CI 1.28–1.54), low Apgar score at 5 min (OR 2.37, 95% CI 1.32–4.27), neonatal hypoglycemia (OR 1.37, 95% CI 1.23–1.53), neonatal respiratory distress (OR 1.77, 95% CI 1.44–2.16), and major congenital malformations (OR 1.37, 95% CI 1.08–1.74).ConclusionOCD in pregnant women might be associated with multiple adverse feto‐maternal outcomes.