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Poor mental health linked to pregnancy complications

Pregnant women with serious mental illnesses are more likely to experience antenatal and birth complications, researchers have found.

Women with schizophrenia, bipolar disorder and other serious mental illnesses had higher-risk pregnancies, more complicated deliveries and their babies were more likely to need special care, the study showed.

A team from the Childbirth and Mental Illness Antenatal Clinic at King Edward Memorial Hospital in Perth reviewed the births of 138 women with mental illnesses from 2007 to 2011.

Forty-four of the women suffered schizophrenia, 56 had bipolar disorder and 38 had non-psychotic serious mental illnesses.

Almost half the women (46 per cent) were smokers, while alcohol and substance use was also common, according to a report published this week in the Medical Journal of Australia.

The rates of gestational diabetes among the women were three times higher than the general population, which may be linked to the high mean body mass index across all groups, which was in the overweight to obese range, the report said.

The women were also more likely to experience pre-eclampsia, and threatened preterm labour.

Almost a third of the women experienced fetal distress or delays in labour progressing, reflected in high rates of non-elective caesareans, particularly among women with schizophrenia (41 per cent).

About 32 per cent of the infants born required special nursery care and the majority had lower measures of infant health at birth than the general population.

Lead researcher and psychiatrist Dr Thinh Nguyen said many new anti-psychotic drugs taken by pregnant women were associated with higher calorie intake and sugar cravings, which could be contributing to the levels of obesity and metabolic-related disorders.

However, he said it was surprising that the infants born had birth weights and levels of prematurity similar to the rest of the population.

Obstetrician Jacqueline Frayne said there were a number of possible reasons behind the levels of birth complications.

"A lot of these women might suffer from gestational diabetes and pre-eclampsia, which might lead to increased rates of fetal distress, it might be something that is linked with the medication use that they are on.

"It also might be something that is intrinsic to the actual psychiatric disease," she told AAP.

Dr Nguyen emphasised that despite the complications the women had successful pregnancies and deliveries.

"Despite a lot of risk factors, these women actually did very well," he said.

He said the study showed that women with mental illnesses needed to be managed comprehensively with psychiatric, obstetric and social work support.

"We hope this (multi-faceted) approach will be taken up by other centres around the country," he said.


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