Unplanned pregnancies and reproductive health among women with bipolar disorder

Marengo, Eliana; Martino, Diego Javier; Igoa, Ana; Scápola, María; Fassi, Guillermo; Baamonde, Mariana Urtueta; Strejilevich, Sergio

doi:10.1016/j.jad.2015.02.033

Cited by 40 publications

(29 citation statements)

References 20 publications

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“…Marengo et al [52], also published after the systematic review was finished, highlighted results related to reproduction decisions of women with BD. They showed that women with BD had more unplanned pregnancies (37.7 % versus 9.6 %) and fewer planned pregnancies (32.8 % versus 78.1 %) than women in the control group.…”

Section: Discussionmentioning

confidence: 99%

“…Logsdon et al 2015 [51] described maternal-infant interaction at 12 months postpartum in women with BD compared to women with unipolar depression and a control group without a major mood disorder. Marengo et al 2015 [52] looked at how women with BD made reproductive decisions. Both of these papers are included in the discussion section only, for noting, as they were published too late to be included in the review.…”

Section: Methodsmentioning

confidence: 99%

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Bipolar disorder in pregnancy and childbirth: a systematic review of outcomes

Rusner

Berg

Begley

2016

BMC Pregnancy Childbirth

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BackgroundBipolar Disorder (BD) is a mental disorder usually diagnosed between 18 and 30 years of age; this coincides with the period when many women experience pregnancy and childbirth. As specific problems have been reported in pregnancy and childbirth when the mother has BD, a systematic review was carried out to summarise the outcomes of pregnancy and childbirth, in mother and child, when the mother has BD diagnosed before pregnancy.MethodsAn a priori protocol was designed and a systematic search conducted in PubMed, CINAHL, Scopus, PsycINFO and Cochrane databases in March 2015. Studies of all designs were included if they involved women with a diagnosis of bipolar disorder prior to pregnancy, who were pregnant and/or followed up to one year postpartum. All stages of inclusion, quality assessment and data extraction were done by two people. All maternal or infant outcomes were examined, and narrative synthesis was used for most outcomes. Meta-analysis was used to achieve a combined prevalence for some outcomes and, where possible, case and control groups were combined and compared.ResultsThe search identified 2809 papers. After screening and quality assessement (using the EPHPP and AMSTAR tools), nine papers were included. Adverse pregnancy outcomes such as gestational hypertension and antepartum haemorrhage occur more frequently in women with BD. They also have increased rates of induction of labour and caesarean section, and have an increased risk of mood disorders in the postnatal period. Women with BD are more likely to have babies that are severely small for gestational age (<2nd-3rd percentile), and it appears that those women not being treated with mood stabilisers in pregnancy might not have an increased risk of having a baby with congenital abnormalities.DiscussionDue to heterogeneity of data, particularly the use of differing definitions of bipolar disorder, narrative synthesis was used for most outcomes, rather than a meta-analysis.ConclusionsIt is evident that adverse outcomes are more common in women with BD and their babies. Large cohort studies examining fetal abnormality outcomes for women with BD who are not on mood stabilisers in pregnancy are required, as are studies on maternal-infant interaction.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-1127-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Bipolar disorder in pregnancy and childbirth: a systematic review of outcomes

Rusner

Berg

Begley

2016

BMC Pregnancy Childbirth

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“…Similar pregnancy rates between WBD and control groups have been reported previously. 29 In our study, although both groups consisted of women of reproductive age, the control group was marginally older, which may explain the higher number of pregnancies found in the latter group. A prior study from Turkey reported higher rates of pregnancies and children in WBD (mean of total number of pregnancies = 3.02±2.0, mean of total number of children = 2.18±1.4).…”

Section: Discussionmentioning

confidence: 48%

“…In parallel with this finding, it has been previously observed that lower levels of planned pregnancies feature among WBD. 29 When we evaluated data from a fertility perspective, we found that the total number of pregnancies was higher in the control group. Similar pregnancy rates between WBD and control groups have been reported previously.…”

Section: Discussionmentioning

confidence: 96%

<p>Impulsivity, Unplanned Pregnancies, and Contraception Among Women with Bipolar Disorder</p>

Eroğlu¹,

Luş

2020

NDT

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Background: Impulsivity is one of the principal symptoms of bipolar and related disorders (BD). Unsafe sex and unplanned pregnancies are serious problems in clinical practice. The aim of this study was to investigate impulsivity levels, contraception methods, and levels of planned pregnancies among women with bipolar and related disorders (WBD). Methods: Fifty-eight euthymic women with BD (bipolar disorder type I, II, or other) were matched by education levels with a control group of 59 healthy women. Data about their demographic, clinical-Barratt Impulsiveness Scale (BIS-11), Hamilton Depression Rating Scale, and Young Mania Rating Scale scores-and reproductive health features were obtained and compared between the groups. Results: No difference was found regarding BIS-11 (total, nonplanning, motor, and attentional subscales) scores between the WBD and control groups. The overall rate of contraception use was higher in WBD (96.6%), but they generally preferred "traditional" methods (i.e., withdrawal and calendar). The total rate of unplanned pregnancies in WBD was 49.52%. Rate of unplanned pregnancies in WBD was significantly different from women without bipolar disorder (49.52% vs 15.04%). Discussion: Levels of impulsivity in euthymic WBD under treatment were similar to those of healthy women in the control sample. WBD paid attention to contraception although they usually used traditional methods. The findings indicate that most WBD use contraception, yet the contraception is potentially ineffective especially if WBD have more unplanned pregnancies. The provision of an effective contraception method in WBD is suggested for all clinicians, in order to prevent sexually transmitted diseases and unplanned pregnancies, and thus protect the health of both mother and fetus.

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“…There is a growing body of research confirming that people with severe mental illness (SMI) have poorer physical health outcomes than the general population on a range of measures, including significantly lowered life expectancy (Thornicroft 2011;Wahlbeck et al 2011). There is evidence to suggest that the sexual health of people with SMI may also be poor (Grover et al 2014;Kaltenthaler et al 2014;Schmidt 2012), and that sexual health problems may be inadequately identified in mental health settings (Happell et al 2012;Howard & Gamble 2011;Marengo et al 2015;Quinn & Browne 2009;. This article reports research that investigated sexual health screening in five community mental health clinics within a large regional mental health service in Victoria, Australia.…”

Section: Introductionmentioning

confidence: 99%

An exploratory investigation of sexual health screening in the first 12 weeks of case management in populations with severe mental illness

Corbett

Elsom

Sands

et al. 2016

Int J Mental Health Nurs

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The sexual health of people with mental illness is commonly overlooked, neglected or inadequately addressed in mental health care, despite evidence showing that people with severe mental illness are more vulnerable to sexually transmitted infections (including HIV), sexual side-effects, and sexual dysfunction than the general population. This article reports a study that investigated sexual health screening in five community mental health clinics within a large a regional health service in Victoria, Australia. The aim of the study was to examine the extent to which sexual health screening is currently undertaken on newly admitted case-managed consumers, and to identify the types of screening undertaken. An exploratory design using retrospective file audit was used in the study. A total of 186 medical records met the study inclusion criteria. The study found that less than 40% of consumers were provided with sexual health screening during their first 12 weeks of case management. The study also found that sexual side-effects, issues of fertility, sexual self-esteem, safe sexual practices, and sexual dysfunction were rarely screened for. Poor sexual health screening has implications for the safety and quality of mental health care and requires targeted research to improve understandings and approaches to care.

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Unplanned pregnancies and reproductive health among women with bipolar disorder

Cited by 40 publications

References 20 publications

Bipolar disorder in pregnancy and childbirth: a systematic review of outcomes

Bipolar disorder in pregnancy and childbirth: a systematic review of outcomes

<p>Impulsivity, Unplanned Pregnancies, and Contraception Among Women with Bipolar Disorder</p>

An exploratory investigation of sexual health screening in the first 12 weeks of case management in populations with severe mental illness

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