Psychiatric and substance use disorders as risk factors for low birth weight and preterm delivery.
OBJECTIVE
We examined the associations between psychiatric and substance use diagnoses and low birth weight (LBW), very low birth weight (VLBW), and preterm delivery among all women delivering in California hospitals during 1995.


METHODS
This population-based retrospective cohort analysis used linked hospital discharge and birth certificate data for 521,490 deliveries. Logistic regression analyses were conducted to assess the associations between maternal psychiatric and substance use hospital discharge diagnoses and LBW, VLBW, and preterm delivery while controlling for maternal demographic and medical characteristics.


RESULTS
Women with psychiatric diagnoses had a significantly higher risk of LBW (adjusted odds ratio [OR] 2.0; 95% confidence interval [CI] 1.7, 2.3), VLBW (OR 2.9; 95% CI 2.1, 3.9), and preterm delivery (OR 1.6; 95% CI 1.4, 1.9) compared with women without those diagnoses. Substance use diagnoses were also associated with higher risk of LBW (OR 3.7; 95% CI 3.4, 4.0), VLBW (OR 2.8; 95% CI 2.3, 3.3), and preterm delivery (OR 2.4; 95% CI 2.3, 2.6).


CONCLUSIONS
Maternal psychiatric and substance use diagnoses were independently associated with low birth weight and preterm delivery in the population of women delivering in California in 1995. Identifying pregnant women with current psychiatric disorders and increased monitoring for preterm and low birth weight delivery among this population may be indicated.
Kelly
Rosemary H
RH
Department of Psychiatry, University of Washington, Seattle, Washington 98195, USA. rhkelly@u.washington.edu
Russo
Joan
J
Holt
Victoria L
VL
Danielsen
Beate H
BH
Zatzick
Douglas F
DF
Walker
Edward
E
Katon
Wayne
W
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D015897:Comorbidity; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D015994:Incidence; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D016015:Logistic Models; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D007752:Obstetric Labor, Premature / Q000453:epidemiology*; D016017:Odds Ratio; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology*