Risk of premature birth higher among mothers with poor mental health – study
New research has indicated women who have at least one contact with mental health services in the seven years prior to their pregnancy are at increased risk of preterm birth.
The study, published in The Lancet Psychiatry, was funded by the National Institute for Health and Care Research (NIHR) and led by researchers at the University of Exeter, King’s College London, the London School of Hygiene and Tropical Medicine and the University of Liverpool.
It analysed data from more than two million pregnant women and found one in ten women who had used mental health services before their pregnancy had a preterm birth, compared to one in fifteen of those who had not.
The researchers also found women who had used mental health services faced a higher risk of giving birth to a baby that was small for its gestational age, increasing from 65 per 1,000 births in women who had not used mental health services to 75 per 1,000 births in women who had.
Researchers concluded information about contacts with mental healthcare before pregnancy can help identify women at increased risk of negative birth outcomes, and who would be most likely to benefit from working with community perinatal mental healthcare teams in coordination with local maternity services.
Senior co-author Professor Louise M Howard OBE, professor of women’s mental health at King’s College London, said: ‘This study highlights the significant extent to which women with pre-existing mental health conditions, particularly those who had a hospital admission and/or recent contact with mental health services, are at risk of adverse obstetric and neonatal outcomes. It is therefore vital that midwives ask in detail about pre-pregnancy mental healthcare contact, and maternity and mental health services then work together to provide appropriate care to reduce this risk.’
Previous research identified a link between poor mental health in pregnant mothers and worse outcomes for babies. However, the new research, which linked hospital and birth registration data with specialist mental health service records, quantifies the effects in greater detail.
Among more than two million pregnant mothers who gave birth to a single child between 2014 and 2018, 7.3% (151,770) had at least one contact with mental health services in the seven years before their pregnancy. Women with psychiatric hospital admissions and women with more recent pre-pregnancy mental healthcare contacts were at the highest risk of birth-related complications.
Senior co-author Professor Heather O’Mahen, from the University of Exeter, said: ‘We’ve known that mental health problems in the mother or birthing person are related to increased obstetric and neonatal risks, but this research has practical implications, helping to guide and focus clinician attention to women who may have had contact with mental health services in the last year or who may have a history of hospital admissions. The NHS has invested significant funds in the past 10 years in perinatal mental health, and these findings support the continued health and mental health implications of providing women and birthing persons with timely and needed treatment and support.’
Image: Patricia Prudente
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