Pregnancy outcomes vary with disease progression in pregnant women with schizophreni

Abstract

Pregnancy outcomes vary with disease progression in pregnant women with schizophrenia Eri Koga 1 , Mio Takami 1 , Yuichi Takahashi 2 , Kazuo Seki 1 , Fumiki Hirahara 3 , Shigeru Aoki 1 1Perinatal Center for Maternity and Neonate, 2Psychiatric Center, Yokohama City University Medical Center, Yokohama 3Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama (Japan) Summary Purpose of investigation: It has been reported that pregnant women with schizophrenia have increased risk of adverse pregnancy outcomes. In this study, the authors aimed to investigate whether being admitted to the psychiatric ward during pregnancy affected pregnancy and neonatal outcomes in pregnant women with schizophrenia. Materials and Methods: One hundred and forty-eight women with schizophrenia who delivered after 22 gestational weeks at the present tertiary care center were classified into the inpatient group who needed to be admitted to the psychiatric ward because of aggravation of schizophrenia symptoms during pregnancy, and the outpatient group who did not require hospitalization. Patient characteristics, maternal outcomes, neonatal outcomes, and postpartum childcare environment were compared and analyzed. Results: There were no significant differences in the maternal outcomes between the inpatient and outpatient groups. The inpatient group had significantly higher rates of neonatal abstinence syndrome (13.8% vs. 0.8%, p = 0.001), placement in a child welfare facility (34.5% vs. 3.4%, p < 0.001), and intervention by hospital social workers (100% vs. 46.2%, p < 0.001) than the outpatient group. Conclusions: Maternal outcomes did not vary in pregnant women with schizophrenia regardless of disease conditions. Meanwhile, in mothers with poorly controlled disease condition, their neonates were at high risk of developing neonatal abstinence syndrome, and moreover, were more likely to need intervention by public authority such as social workers and child welfare facilities.