Schizophrenia pregnancies should be given greater health priority in the global health agenda: results from a large-scale meta-analysis of 43,611 deliveries of women with schizophrenia and 40,948,272 controls

Etchecopar‐Etchart, Damien; Mignon, Roxane; Boyer, Laurent; Fond, Guillaume

doi:10.1038/s41380-022-01593-9

Cited by 10 publications

(8 citation statements)

References 85 publications

(79 reference statements)

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“…On a positive note, a majority of women were breastfeeding and had contraception plans on discharge from hospital. While further large-scale research is needed, the data available supports the notion that pregnant women with BPD should be given health priority, much like the call for pregnant women with schizophrenia 13 and renews the call for the development of clinical practice guidelines specifically for this population. 9 Beyond physical health complications, the management of pregnant women with BPD appears complex and challenging as evident by the polypharmacy exposure and comorbid psychosocial adversities.…”

Section: Discussionmentioning

confidence: 82%

Outcomes for pregnant women with Borderline Personality Disorder who attended a specialist antenatal service

Nguyen,

Frayne,

Watson

et al. 2023

Australas Psychiatry

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Objective Our study focussed on the obstetric and psychosocial outcomes of pregnant women with Borderline Personality Disorder (BPD) who received care via a specialist antenatal clinic in Western Australia. Method This study is a retrospective examination of outcomes for 80 women with a confirmed diagnosis of BPD, with findings compared with published population outcome data for the state. Results Pregnant women with BPD appeared to be at a risk of complications including pre-eclampsia and special care nursery admission for their newborns when compared to population data. Furthermore, the studied women had elevated rates of psychiatric admissions during pregnancy, child protection involvement, and domestic violence. Polypharmacy exposure was frequent, with the likely impact on obstetric and neonatal outcomes requiring further study. Conclusion The findings reinforced the notion that pregnant women with BPD experience complex multifaceted vulnerabilities and require enhanced multidisciplinary care. Our study further calls for the development of clinical practice guidelines for managing BPD in the perinatal period.

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Section: Discussionmentioning

confidence: 82%

Outcomes for pregnant women with Borderline Personality Disorder who attended a specialist antenatal service

Nguyen,

Frayne,

Watson

et al. 2023

Australas Psychiatry

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“…We used the LMS total score to account for the significant heterogeneity in studies using only low birth weight (2500 g), which might be attributable to ‘population shifts’ across studies (Cannon, Jones, & Murray, 2002). Moreover, the effect sizes of the relationships between OCs and schizophrenia are generally small with odds ratios less than 2 (Cannon et al, 2002; Etchecopar-Etchart, Mignon, Boyer, & Fond, 2022). And evidence from the last two decades provided updated consistency and magnitude of association of numerous OCs contributing to increase the risk for psychotic disorders (Davies et al, 2020).…”

Section: Methodsmentioning

confidence: 99%

Effect of polygenic risk score, family load of schizophrenia and exposome risk score, and their interactions, on the long-term outcome of first-episode psychosis

et al. 2023

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Background Consistent evidence supports the involvement of genetic and environmental factors, and their interactions, in the etiology of psychosis. First-episode psychosis (FEP) comprises a group of disorders that show great clinical and long-term outcome heterogeneity, and the extent to which genetic, familial and environmental factors account for predicting the long-term outcome in FEP patients remains scarcely known. Methods The SEGPEPs is an inception cohort study of 243 first-admission patients with FEP who were followed-up for a mean of 20.9 years. FEP patients were thoroughly evaluated by standardized instruments, with 164 patients providing DNA. Aggregate scores estimated in large populations for polygenic risk score (PRS-Sz), exposome risk score (ERS-Sz) and familial load score for schizophrenia (FLS-Sz) were ascertained. Long-term functioning was assessed by means of the Social and Occupational Functioning Assessment Scale (SOFAS). The relative excess risk due to interaction (RERI) was used as a standard method to estimate the effect of interaction of risk factors. Results Our results showed that a high FLS-Sz gave greater explanatory capacity for long-term outcome, followed by the ERS-Sz and then the PRS-Sz. The PRS-Sz did not discriminate significantly between recovered and non-recovered FEP patients in the long term. No significant interaction between the PRS-Sz, ERS-Sz or FLS-Sz regarding the long-term functioning of FEP patients was found. Conclusions Our results support an additive model of familial antecedents of schizophrenia, environmental risk factors and polygenic risk factors as contributors to a poor long-term functional outcome for FEP patients.

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“…1,2,4,5 Moreover, studies also established severe maternal and neonatal adverse consequences. [6][7][8] Mothers with psychiatric disorders are at higher risk of admission to an intensive care unit, unplanned cesarean section, gestational diabetes, preeclampsia, induced labor, and have lower rates of breastfeeding. 6,7,9 Neonates more often have low 5-min Apgar scores, low birthweight or are born preterm.…”

Section: Introductionmentioning

confidence: 99%

“…[6][7][8] Mothers with psychiatric disorders are at higher risk of admission to an intensive care unit, unplanned cesarean section, gestational diabetes, preeclampsia, induced labor, and have lower rates of breastfeeding. 6,7,9 Neonates more often have low 5-min Apgar scores, low birthweight or are born preterm. 6,9,10 Besides, psychiatric disorders may increase the risk for unintended pregnancies (UPs).…”

Section: Introductionmentioning

confidence: 99%

“…Women with previous psychiatric disorders such as psychotic, bipolar, and depressive disorders have a considerable risk of relapse in the peripartum period 1,2,4,5 . Moreover, studies also established severe maternal and neonatal adverse consequences 6–8 . Mothers with psychiatric disorders are at higher risk of admission to an intensive care unit, unplanned cesarean section, gestational diabetes, preeclampsia, induced labor, and have lower rates of breastfeeding 6,7,9 .…”

Section: Introductionmentioning

confidence: 99%

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Pregnancy intention in relation to maternal and neonatal outcomes in women with versus without psychiatric diagnoses

Schonewille,

Jonkman,

van Kempen

et al. 2023

Acta Psychiatr Scand

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BackgroundStudies have identified adverse maternal and neonatal outcomes for women with psychiatric disorders. Additionally, psychiatric disorders may pose an increased risk for unintended pregnancies (UPs) which in turn may also impact negatively on outcomes. The present study aims to compare the incidence of UPs in women with versus without current/past psychiatric diagnoses and investigates whether psychiatric history modifies the relation between delivery outcomes in women with and without UPs.MethodsA retrospective cohort was compiled of women who gave birth in a large hospital in Amsterdam, the Netherlands. Women ≥18 years old with singleton pregnancies and birth registrations in the electronic patient file during January 1, 2015 to March 1, 2020 were included. Patient characteristics (including pregnancy intention and psychiatric history), maternal (gestational diabetes, mode of delivery) and neonatal outcomes (e.g., gestational age [GA], birthweight and Apgar scores) were registered by health care providers in hospital charts. Incidence of UPs was compared between women with versus without current/past psychiatric diagnoses. Maternal and neonatal outcomes were compared between women with versus without UPs with linear or logistic regression models adjusted for relevant confounders with an interaction term for UP with current/past psychiatric diagnoses.ResultsWe included 1219 women with and 1093 women without current/past psychiatric diagnoses. Current/past psychiatric diagnoses were significantly associated with UPs after adjustment for confounders (39.0% vs. 29.6%, OR 1.56, CI 1.23–2.00, p < 0.001). In sub‐analyses, women with depressive (OR 1.67, CI 1.24–2.26, p = 0.001), personality (OR 2.64, CI 1.38–5.11, p = 0.004) and substance‐related and addictive disorders (OR 4.29, CI 1.90–10.03, p = 0.001) had higher odds of UPs compared to women without current/past psychiatric diagnoses. Amongst women with UPs, current/past psychiatric diagnoses did not modify maternal or neonatal outcomes, except for GA at delivery as women with both UPs and current/past psychiatric diagnosis had a 2.21‐day higher mean GA at delivery than women in the reference group (p‐value interaction = 0.001).ConclusionsCurrent/past psychiatric diagnoses are associated with a higher odd of UPs. In our sample, maternal and neonatal outcomes were comparable for women with and without UPs and these results were similar for women with and without current/past psychiatric diagnoses, except for GA at delivery. Although our study is limited by several factors, we found that women with current/past psychiatric diagnoses, irrespective of pregnancy planning status, do not have more adverse maternal or pregnancy outcomes. Increased efforts are needed to ensure that psychoeducation and conversations about pregnancy planning and UPs are available for women with current/past psychiatric diagnoses.

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Schizophrenia pregnancies should be given greater health priority in the global health agenda: results from a large-scale meta-analysis of 43,611 deliveries of women with schizophrenia and 40,948,272 controls

Cited by 10 publications

References 85 publications

Outcomes for pregnant women with Borderline Personality Disorder who attended a specialist antenatal service

Outcomes for pregnant women with Borderline Personality Disorder who attended a specialist antenatal service

Effect of polygenic risk score, family load of schizophrenia and exposome risk score, and their interactions, on the long-term outcome of first-episode psychosis

Pregnancy intention in relation to maternal and neonatal outcomes in women with versus without psychiatric diagnoses

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