title: Maternal psychiatric disorders and risk of preterm birth.
abstract: OBJECTIVE
  To study the effect of maternal psychiatric disorders (depression, anxiety disorder, bipolar disease, schizophrenia, unspecified psychiatric disorder, and comorbid conditions) and odds of preterm birth.
  
  
  METHODS
  The Consortium on Safe Labor (2002-2008), an observational cohort with 12 centers from across the United States included 223,394 singleton pregnancies with clinical data obtained from electronic medical records and maternal diagnoses of psychiatric disorders from maternal discharge summaries. Length of gestation was based on the best clinical estimate and categorized as birth less than 39, less than 37, less than 34, and less than 28 weeks' gestation. The adjusted odds ratios (ORs) with 95% confidence intervals of birth were estimated by logistic regression with generalized estimating equations.
  
  
  RESULTS
  Any maternal psychiatric disorder was associated with odds of birth less than 39 weeks' gestation (odds ratio [OR] = 1.32, 95% confidence interval = 1.28-1.37), less than 37 weeks' gestation (OR = 1.45, 1.38-1.52), less than 34 weeks' gestation (OR = 1.47, 1.35-1.59), and less than 28 weeks' gestation (OR = 1.57, 1.36-1.82). Specifically, odds of birth less than 37 weeks' gestation were associated with maternal depression (OR = 1.31, 1.23-1.40), anxiety disorder (OR = 1.68, 1.41-2.01), depression with anxiety disorder (OR = 2.31, 1.93-2.78), bipolar disease (OR = 1.54, 1.22-1.94), bipolar disease with depression and/or anxiety disorder (OR = 1.70, 1.30-2.22), and unspecified psychiatric disorder (OR = 1.52, 1.41-1.64).
  
  
  CONCLUSIONS
  Maternal psychiatric disorders, especially comorbid psychiatric conditions, were associated with increased likelihood of preterm birth.
authors.affiliation: Northern Finland Laboratory Centre NordLab, Oulu, Finland; Department of Clinical Chemistry, University of Oulu, Oulu, Finland; Medical Research Centre, Oulu University Hospital and University of Oulu, Oulu, Finland; Department of Chronic Disease Prevention, National Institute for Health and Welfare, Oulu, Finland.
authors.forename: Tuija
authors.initials: T
authors.lastname: Männistö
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
authors.forename: Pauline
authors.initials: P
authors.lastname: Mendola
authors.affiliation: School of Public Health, City University of New York, New York.
authors.forename: Michele
authors.initials: M
authors.lastname: Kiely
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
authors.forename: Jennifer
authors.initials: J
authors.lastname: O'Loughlin
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD; Epidemiology Department, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill.
authors.forename: Emily
authors.initials: E
authors.lastname: Werder
authors.affiliation: Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Departments of Obstetrics and Gynecology and Population Health Sciences, School of Medicine and Public Heath, University of Wisconsin-Madison, Madison.
authors.forename: Deborah B
authors.initials: DB
authors.lastname: Ehrenthal
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD. Electronic address: katherine.grantz@nih.gov.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Grantz
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D016015:Logistic Models; D001523:Mental Disorders / Q000150:complications*; D016017:Odds Ratio; D011247:Pregnancy; D047928:Premature Birth / Q000209:etiology* / Q000523:psychology; D012307:Risk Factors; D014481:United States
keywords: Anxiety; Bipolar disorder; Depression; Preterm birth; Psychiatric diagnosis; Schizophrenia