title: A comparison of maternal and neonatal outcomes of pregnancy with mental disorders: results of an analysis using propensity score-based weighting.
abstract: OBJECTIVE
  To assess and compare maternal and neonatal outcomes of pregnancy with or without mental disorders.
  
  
  METHODS
  We performed a retrospective cohort study of births at our institution from January 2009 to December 2011, which included all live singleton births during these 3 years. Women emergently transferred to our institution in the middle of their pregnancies were excluded. Associations between mental disorders and perinatal outcomes were estimated using statistical analysis, and multivariable analysis was performed using propensity score-based weighting.
  
  
  RESULTS
  A total of 1,166 women were included, 152 (13.0 %) of whom had mental disorders. Comparison of maternal characteristics showed that women with mental disorders were significantly more likely to be multiparous, smokers, recipients of public assistance, unmarried, and to have inadequate perinatal care. Comparison of perinatal outcomes showed that preterm births (PTB) before 37 weeks were significantly increased in women with mental disorders (10.5 vs. 6.0 %, P = 0.037). There were no significant differences in low birth weight (LBW), pregnancy-induced hypertension, and gestational diabetes mellitus. Multivariable analysis using propensity score weighting showed that after adjusting for other factors, women with mental disorders were more likely than women without mental disorders to have PTB before 34 weeks [adjusted odds ratio (OR) 4.79, 95 % confidence interval (CI) 1.49-15.4; P = 0.009], PTB before 37 weeks (adjusted OR 2.46, 95 % CI 1.62-3.69; P < 0.001), or LBW (adjusted OR 1.83; 95 % CI 1.32-2.55; P < 0.001).
  
  
  CONCLUSIONS
  Maternal mental disorders were associated with adverse birth outcomes and socioeconomic disadvantage.
authors.affiliation: Department of Obstetrics and Gynecology, Osaka General Medical Center, 3-1-56 Bandaihigashi, Sumiyoshi-ku, Osaka, 558-0056, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Kitai
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Komoto
authors.forename: Reisa
authors.initials: R
authors.lastname: Kakubari
authors.forename: Hisashi
authors.initials: H
authors.lastname: Konishi
authors.forename: Eriko
authors.initials: E
authors.lastname: Tanaka
authors.forename: Saori
authors.initials: S
authors.lastname: Nakajima
authors.forename: Miho
authors.initials: M
authors.lastname: Muraji
authors.forename: Hiromi
authors.initials: H
authors.lastname: Ugaki
authors.forename: Hidenori
authors.initials: H
authors.lastname: Matsunaga
authors.forename: Masahiko
authors.initials: M
authors.lastname: Takemura
mesh_terms: D000328:Adult; D016640:Diabetes, Gestational / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology / Q000209:etiology; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008423:Maternal Age; D001523:Mental Disorders / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D016017:Odds Ratio; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D011256:Pregnancy Outcome / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology / Q000209:etiology; D057216:Propensity Score; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult