Temporal trends in general and age-specific fertility rates among women with schizophrenia (1996-2009): a population-based study in Ontario, Canada.
OBJECTIVE
There is substantial evidence that women with schizophrenia in many parts of the world have fewer children than their peers. Our objective was to analyze recent trends in general and age-specific fertility rates among women with schizophrenia in Ontario, Canada.


METHODS
We conducted a repeated cross-sectional population-based study from 1996 to 2009 using population-based linked administrative databases for the entire province of Ontario. Women aged 15-49 years were classified into schizophrenia and non-schizophrenia groups in each successive 12-month period. Annual general and age-specific fertility rates were derived.


RESULTS
The general fertility rate (GFR) among women with schizophrenia was 1.16 times higher in 2007-2009 than in 1996-1998 (95% confidence interval [CI] 1.04-1.31). The annual GFR ratio of women with vs. without schizophrenia was 0.41 (95% CI 0.36-0.47) in 2009, which was slightly higher than the same ratio in 1996 of 0.30 (95% CI 0.25-0.35). Annual age-specific fertility rates (ASFR) increased over time among women with schizophrenia aged 20-24, 25-29, 35-39 and 40-44 years, but the increase was not always statistically significant. Among women aged 20-24 years, the ASFR ratio in women with vs. without schizophrenia was not significant by the end of the study period (0.93, 95% CI 0.70-1.22).


CONCLUSIONS
The general fertility rate among women with schizophrenia appears to have increased modestly over the past 13 years. Clinical care and health policy should consider new strategies that focus on the mental health of women with schizophrenia as new mothers, while optimizing healthy pregnancies and child rearing.
Women's College Hospital and Women's College Research Institute, 76 Grenville St., Toronto, Ontario, Canada M5S 1B2. simone.vigod@wchospital.ca
Simone N
SN
Vigod
Mary V
MV
Seeman
Joel G
JG
Ray
Geoffrey M
GM
Anderson
Cindy Lee
CL
Dennis
Sophie
S
Grigoriadis
Andrea
A
Gruneir
Paul A
PA
Kurdyak
Paula A
PA
Rochon
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001723:Birth Rate / Q000639:trends*; D018672:Community Health Planning; D003430:Cross-Sectional Studies; D005260:Female; D005298:Fertility; D006801:Humans; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D011247:Pregnancy; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012559:Schizophrenia / Q000453:epidemiology* / Q000503:physiopathology*; D055815:Young Adult