Judd Fiona, Komiti Angela, Sheehan Penny, Newman Louise, Castle David, Everall Ian
Department of Psychiatry, The University of Melbourne, Melbourne, Australia; The Centre for Women's Mental Health, Royal Women's Hospital, Melbourne, Australia.
Department of Psychiatry, The University of Melbourne, Melbourne, Australia; The Centre for Women's Mental Health, Royal Women's Hospital, Melbourne, Australia.
Schizophr Res. 2014 Aug;157(1-3):305-9. doi: 10.1016/j.schres.2014.05.030. Epub 2014 Jun 13.
Women with schizophrenia and bipolar disorder are at a higher risk of obstetric and neonatal complications. The aim of this study was to better understand the factors that may influence these adverse outcomes.
We examined obstetric and neonatal outcomes of pregnant women with schizophrenia and bipolar disorder and factors possibly influencing these outcomes. A retrospective review of the medical history of 112 women with a DSM-IV diagnosis of schizophrenia or bipolar disorder was undertaken. Data for controls were extracted from the hospital's electronic birth record data.
Women with schizophrenia and bipolar disorder presented later for their first antenatal visit and had higher rates of smoking and illicit drug use than the control group. They also had higher rates of pre-eclampsia and gestational diabetes. Their infants were less likely to have Apgar scores 8-10 at both 1 and 5minutes and were more likely to be admitted to special care/neonatal intensive care nursery than the infants of controls. The rate of pre-term birth was significantly increased in the women with schizophrenia and bipolar disorder. Pre-term birth and admission to special care/neonatal intensive care were predicted by smoking and illicit drug use.
These data point to potentially modifiable factors as significant contributors to the high rate of adverse obstetric and neonatal outcomes in women with mental illness. Comprehensive management of women with mental illness prior to, during pregnancy and in the postnatal period may have long-term benefits for their offspring.
患有精神分裂症和双相情感障碍的女性出现产科和新生儿并发症的风险更高。本研究的目的是更好地了解可能影响这些不良结局的因素。
我们研究了患有精神分裂症和双相情感障碍的孕妇的产科和新生儿结局以及可能影响这些结局的因素。对112名符合DSM-IV精神分裂症或双相情感障碍诊断标准的女性的病史进行了回顾性研究。对照组的数据从医院的电子出生记录数据中提取。
患有精神分裂症和双相情感障碍的女性首次产前检查时间较晚，吸烟和使用非法药物的比例高于对照组。她们患先兆子痫和妊娠期糖尿病的比例也更高。与对照组的婴儿相比，她们的婴儿在出生1分钟和5分钟时阿氏评分达到8 - 10分的可能性较小，且更有可能被送入特殊护理/新生儿重症监护病房。患有精神分裂症和双相情感障碍的女性早产率显著增加。吸烟和使用非法药物可预测早产以及送入特殊护理/新生儿重症监护病房的情况。
这些数据表明，一些潜在的可改变因素是导致患有精神疾病的女性产科和新生儿不良结局发生率高的重要原因。对患有精神疾病的女性在怀孕前、怀孕期间和产后进行综合管理可能会对其后代产生长期益处。
