The Relationship between Maternal Personality Disorder and Early Birth Outcomes: A Systematic Review and Meta-Analysis

Marshall, Claire; Jomeen, Julie; Huang, Chao; Martin, Colin R.

doi:10.3390/ijerph17165778

Cited by 6 publications

(3 citation statements)

References 74 publications

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“…A recent systematic review and meta-analysis (including five studies of 1114 women with a personality disorder and 8,527,780 control women) reported a greater risk of preterm birth, low birthweight and low Apgar score (pooled ORs ranging from 2.0 to 2.6) for women with a personality disorder ( Marshall et al, 2020 ). In line with this, we showed an association between maternal personality disorder and some perinatal outcomes (preterm birth and foetal distress).…”

Section: Discussionmentioning

confidence: 99%

Perinatal outcomes of Aboriginal women with mental health disorders

Adane

Shepherd

Walker

et al. 2023

Aust N Z J Psychiatry

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Objective: Maternal mental disorders have been associated with adverse perinatal outcomes such as low birthweight and preterm birth, although these links have been examined rarely among Australian Aboriginal populations. We aimed to evaluate the association between maternal mental disorders and adverse perinatal outcomes among Aboriginal births. Methods: We used whole population-based linked data to conduct a retrospective cohort study ( N = 38,592) using all Western Australia singleton Aboriginal births (1990–2015). Maternal mental disorders were identified based on the International Classification of Diseases diagnoses and grouped into six broad diagnostic categories. The perinatal outcomes evaluated were preterm birth, small for gestational age, perinatal death, major congenital anomalies, foetal distress, low birthweight and 5-minute Apgar score. We employed log-binomial/-Poisson models to calculate risk ratios and 95% confidence intervals. Results: After adjustment for sociodemographic factors and pre-existing medical conditions, having a maternal mental disorder in the five years before the birth was associated with adverse perinatal outcomes, with risk ratios (95% confidence intervals) ranging from 1.26 [1.17, 1.36] for foetal distress to 2.00 [1.87, 2.15] for low birthweight. We found similar associations for each maternal mental illness category and neonatal outcomes, with slightly stronger associations when maternal mental illnesses were reported within 1 year rather than 5 years before birth and for substance use disorder. Conclusions: This large population-based study demonstrated an increased risk of several adverse birth outcomes among Aboriginal women with mental disorders. Holistic perinatal care, treatment and support for women with mental disorders may reduce the burden of adverse birth outcomes.

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Section: Discussionmentioning

confidence: 99%

Perinatal outcomes of Aboriginal women with mental health disorders

Adane

Shepherd

Walker

et al. 2023

Aust N Z J Psychiatry

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“…Overall, from the 166 associations that have been examined, only 4.2% had epidemiologically robust results with no suggestion of bias, as can be inferred by substantial heterogeneity between studies, small-study effects, and excess significance bias. Seven risk factors were supported by robust evidence, including amphetamine exposure [ 53 ], isolated single umbilical artery [ 60 ], maternal personality disorder [ 70 ], sleep-disordered breathing measured with objective assessment [ 80 ], prior induced termination of pregnancy with vacuum aspiration compared to no termination [ 98 ], low gestational weight gain compared to normal weight gain [ 107 ], and interpregnancy interval following miscarriage less than 6 months compared to more than 6 months [ 108 ]. Several others had highly suggestive evidence including intimate partner violence [ 39 ] and unmarried women [ 52 ], cancer survivors [ 41 ], African/Black race [ 49 ], placental previa [ 43 ], hemorrhagic and hepatic disorders [ 68 ], endometriosis [ 8 ], chronic kidney disease [ 104 ], and treatments for CIN [ 112 ].…”

Section: Discussionmentioning

confidence: 99%

Risk factors for preterm birth: an umbrella review of meta-analyses of observational studies

Mitrogiannis,

Evangelou,

Efthymiou

et al. 2023

BMC Med

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Background Preterm birth defined as delivery before 37 gestational weeks is a leading cause of neonatal and infant morbidity and mortality. The aim of this study is to summarize the evidence from meta-analyses of observational studies on risk factors associated with PTB, evaluate whether there are indications of biases in this literature, and identify which of the previously reported associations are supported by robust evidence. Methods We searched PubMed and Scopus until February 2021, in order to identify meta-analyses examining associations between risk factors and PTB. For each meta-analysis, we estimated the summary effect size, the 95% confidence interval, the 95% prediction interval, the between-study heterogeneity, evidence of small-study effects, and evidence of excess-significance bias. Evidence was graded as robust, highly suggestive, suggestive, and weak. Results Eighty-five eligible meta-analyses were identified, which included 1480 primary studies providing data on 166 associations, covering a wide range of comorbid diseases, obstetric and medical history, drugs, exposure to environmental agents, infections, and vaccines. Ninety-nine (59.3%) associations were significant at P < 0.05, while 41 (24.7%) were significant at P < 10−6. Ninety-one (54.8%) associations had large or very large heterogeneity. Evidence for small-study effects and excess significance bias was found in 37 (22.3%) and 12 (7.2%) associations, respectively. We evaluated all associations according to prespecified criteria. Seven risk factors provided robust evidence: amphetamine exposure, isolated single umbilical artery, maternal personality disorder, sleep-disordered breathing (SDB), prior induced termination of pregnancy with vacuum aspiration (I-TOP with VA), low gestational weight gain (GWG), and interpregnancy interval (IPI) following miscarriage < 6 months. Conclusions The results from the synthesis of observational studies suggest that seven risk factors for PTB are supported by robust evidence. Routine screening for sleep quality and mental health is currently lacking from prenatal visits and should be introduced. This assessment can promote the development and training of prediction models using robust risk factors that could improve risk stratification and guide cost-effective preventive strategies. Trial registration PROSPERO 2021 CRD42021227296.

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“…Its aetiology is increasingly understood in the context of repeated disruptive and abusive experiences in childhood. There is evidence suggesting that personality disorders are associated with worse obstetric outcomes including preterm birth, low birth weight and low Apgar score [22].…”

Section: Other Mental Disordersmentioning

confidence: 99%

Mental disorder in pregnancy and the early postpartum

Cantwell

2021

Anaesthesia

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Perinatal mental illness is common, affecting up to 20% of women, but remains under‐recognised and under‐diagnosed. It may have adverse effects on pregnancy and neonatal outcomes, and mental disorder remains one of the leading causes of maternal death in the UK. Women with mental ill health face difficult decisions in balancing risks and benefits of treatment. Stigma related to mental disorder may lead to non‐engagement with maternity care. Some disorders bring specific challenges for anaesthetists working in maternity settings and it is vital that anaesthetists have knowledge of these disorders so they may offer care which is sensitive and appropriate.

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The Relationship between Maternal Personality Disorder and Early Birth Outcomes: A Systematic Review and Meta-Analysis

Cited by 6 publications

References 74 publications

Perinatal outcomes of Aboriginal women with mental health disorders

Perinatal outcomes of Aboriginal women with mental health disorders

Risk factors for preterm birth: an umbrella review of meta-analyses of observational studies

Mental disorder in pregnancy and the early postpartum

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