Mentally ill at risk of dangerous pregnancy complication

Pregnant woman

New research by Murdoch University and The University of Western Australia has revealed that women with severe mental illness have a greater chance of developing a serious medical complication during pregnancy.

A study published today in the Australian and New Zealand Journal of Obstetrics & Gynaecology, revealed women suffering from schizophrenia and other psychotic disorders were three times more likely to develop gestational diabetes mellitus.

Dr Jacqueline Frayne, from UWA’s Medical School said the women were at higher risk of more complicated pregnancies and required careful monitoring and care.

“Gestational diabetes carries serious risks for the mother, the birth, the baby and the child later in life, including increased risk of preterm birth, having a larger than normal baby and low blood sugar in the infant following birth,” Dr Frayne said.

“There is also a higher risk of both the mother and child developing Type 2 diabetes later in life.”

Researchers conducted a retrospective analysis of 539 pregnant women with severe mental disorders, recording the occurrence of gestational diabetes, types of medication, body mass index, smoking, alcohol and illicit substance abuse.

They found that nearly 21 per cent of these women suffered gestational diabetes compared to just 8.3 per cent in the average population. Specific antipsychotic medications were also associated with a higher risk of gestational diabetes even after controlling for maternal mental illness, age and body mass index.

Dr Frayne said it was hoped growing awareness of the importance of mental and physical health in childbearing women with psychotic disorders would lead to improved care.

“There is an urgent need to further understand the risks and benefits of treatment options, so we can improve models of care and ensure optimal outcomes for both mother and child,” she said.

“All women in Australia are screened for gestational diabetes at 28 weeks of pregnancy, however these findings suggest women with psychotic disorders and those on specific antipsychotic treatment could be considered for earlier screening for gestational diabetes in pregnancy.

“This highlights the importance of specialist multi-disciplinary antenatal care in pregnancy for women with severe mental illness such as the CAMI (Childbirth and Mental Illness Antenatal Clinic) at King Edward Memorial Hospital and at Mercy Hospital for Women.”

The study also involved King Edward Memorial Hospital in WA and Mercy Hospital for Women in Victoria. Results will inform the ongoing Mercy Pregnancy Emotional Wellbeing Study, which is examining antidepressant use and depression in pregnancy on maternal and infant health outcomes.

The wellbeing study includes women and infants from Melbourne, Perth, Kalgoorlie, Geraldton and Bunbury.

/University Release. View in full here.