Pre-existing mental health issues significantly raise risks for preterm birth and low birth weight in women
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Key Takeaway
Women with pre-existing mental health problems have significantly higher risks of preterm birth, low birth weight, and neonatal unit admission.
A systematic review and meta-analysis encompassing 33 studies examined the impact of pre-existing mental health conditions on pregnancy outcomes in women. The research compared these women against those without such conditions to isolate specific risks associated with mental health history.
The analysis found significantly higher odds of preterm birth, with an adjusted odds ratio of 1.41. Similarly, the risk of delivering a low birth weight infant increased, showing an adjusted odds ratio of 1.28. These statistics highlight a clear correlation between prior mental health struggles and compromised fetal growth.
Additional risks included a higher likelihood of the baby being small for gestational age and increased chances of neonatal unit admission. The adjusted odds ratio for neonatal unit admission was 1.44, indicating a substantial elevation in risk. No consistent associations were found regarding the mode of birth.
The study concludes that early identification of mental health issues is vital. Strengthening preconception and maternity care planning for these women can mitigate these risks. Targeted support before pregnancy is essential to ensure better outcomes for both mother and child.
View Original Abstract ↓
OBJECTIVES: To synthesise evidence on the association between any diagnosed or self-reported mental health problems prior to pregnancy (pre-existing mental health problems) and birth outcomes including preterm birth (PTB), low birth weight (LBW), small for gestational age (SGA), neonatal unit (NNU) admission and mode of birth (instrumental birth, planned or unplanned caesarean section).
METHODS: Systematic searches were conducted in MEDLINE, CINAHL, Embase and PsycINFO in December 2024 for studies examining the association between any pre-existing mental health problems and PTB, LBW, SGA, NNU admission and mode of birth. Only articles published in English were included with no restriction on year of publication. Two reviewers independently screened studies and extracted data. Study quality was assessed using the Newcastle-Ottawa Scale and Joanna Briggs Institute checklists. Random-effects meta-analyses were conducted to pool crude and adjusted ORs (aORs) and risk ratios (aRR) with 95% CIs. ORs and RRs were analysed separately. Between-study heterogeneity was quantified using the I statistic.
RESULTS: Of 15 467 records screened, 33 studies met the inclusion criteria. Women with any pre-existing mental health problems had higher odds and risks of adverse birth outcomes, including PTB (aOR 1.41, 95% CI 1.27 to 1.56) (aRR 1.36, 95% CI 1.21 to 1.51), LBW (aOR 1.28, 95% CI 1.22 to 1.33) (aRR 1.32, 95% CI 1.04 to 1.68), SGA (aOR 1.27, 95% CI 1.07 to 1.51) (aRR 1.34, 95% CI 1.19 to 1.51) and NNU admission (aOR 1.44, 95% CI 1.19 to 1.74). Adjusted estimates were based on multivariable models that commonly controlled for maternal age, parity and socio-demographic factors. No consistent associations were observed between pre-existing mental health problems and mode of birth.
CONCLUSIONS: Pre-existing mental health problems were associated with increased risks and odds of several adverse birth outcomes. These findings highlight the importance of early identification and targeted support for women with mental health problems before pregnancy to strengthen preconception and maternity care planning.
PROSPERO REGISTRATION NUMBER: CRD42023485834.
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