Perinatal management of pregnant women with mental illness

Abstract

Objective : The purpose of this study is to compare pregnant women with mental illness to healthy pregnant women from the perspective of perinatal management. Subjects and methods : This study is a retrospective comparative controlled trial. Twenty-two pregnant women with mental illness were included in subjective group abbreviated as A, and 108 healthy pregnant women were included in controlled group abbreviated B. The 14 items shown below were compared among the two groups with statistical analysis. (1)The percentage of multipara (2)Maternal age (year) (3)Body mass index (BMI) immediately before pregnancy (4)Alcohol consumers before pregnancy (%) (5)Smokers before pregnancy (%) (6)Interval between obstetrical examinations (weeks) (7)Weight gain during pregnancy/Gestational age at delivery (kg/week) (8) Alcohol consumers during pregnancy (%) (9)Smokers during pregnancy (%) (10)Patients with pregnancy induced hypertension (PIH) (11)Patients with preterm delivery (%) (12) Gestational age at delivery (weeks) (13)Caesarean section (%) (14)Birth weight (g) (15)Apgar score 5 minutes after birth (16)Breast feeding (%) Results : The significance was not recognized on the percentage of multipara, maternal age, BMI, interval between obstetrical exams. Weight gain per week was higher in A (p<0.01). The percentage of alcohol consumers before and during pregnancy was changed from 13.6% to 9.1% in A, from 46.2% to 7.4% in B. The percentage of smokers before and during pregnancy was changed from 31.8% to 31.8% in A, from 17.5% to 8.3% in B. The significance was not recognized on the incidence of PIH and preterm delivery. Gestational age at delivery was earlier and Birth weight was lower in A (p<0.01). The percentage of Caesarean section was 50% in A and 13.8% in B (p<0.01). The percentage of breast feeding was 27.2% in A and 100% in B (p<0.01). Conclusion : Pregnant women with mental illness may not have adequate awareness of self-management because of the higher rate of weight gain and smoking during pregnancy. On the other hand, for weight gain, it is necessary to consider the effects of antipsychotics. Aggressive intervention in labor is required in the case that psychiatric symptoms get worse. This results in an earlier gestational week at delivery, a lower birth weight of infants, and a higher rate of Caesarean section deliveries. The rate of breast feeding is lower because of the medication.