Title: Fetomaternal Outcome of Major Psychiatric Problems in Pregnancy
Authors: Dr Sujamol Jacob, Dr Shabnam A P
DOI: https://dx.doi.org/10.18535/jmscr/v5i3.68
Abstract
Background: Women in childbearing age group are often vulnerable to mood and anxiety disorders. Approximately 30% of women experience some type of psychological disturbances during their life time. Women with these disturbances may experience profound changes during pregnancy. Evidence suggests that these disorders can adversely affect pregnancy outcome. So it is important that physicians understand the course of these disorders so that they can appropriately counsel women who are or intend to become pregnant. However systematic prospective data are limited on the outcome of mood and anxiety disorders in pregnancy. This study is designed to assess the feto maternal outcome of major psychiatric disorders in pregnancy.
Methods: This is a hospital based cohort study conducted in the Department of Obstetrics and Gynaecology, Sree Avittom Thirunal Hospital, Govt. Medical College, Trivandrum, Kerala. Known psychiatric patients registered for antenatal checkup are included in the study. This includes patients with or without treatment and also drug defaulters. Details of psychiatric illness are collected using a structured questionnaire and analysis done by SSPS software and analyzed by calculating chi square and P value (<.0.05 is considered significant)
Results: The study identified three major psychiatric problems in pregnancy they are depression, bipolar mood disorders and schizophrenia. Pregnancy outcome measures showed higher incidence of miscarriage rates, preterm labour and cesarean section rates in these patients. Neonatal outcome analysis showed a significant increase in low birth weight, poor 1 minute Apgar scores and poor breast feeding in this group .Study also identified the need for continued psychiatric counseling and drug therapy in the puerperium to prevent postpartum exacerbation.
Conclusion: Pregnancy is a major psychological as well as a major physiological event. Virtually all women can develop mental disorders during pregnancy as poverty, extreme stress, marital conflict and low social supports tend to increase the risk forspecific disorders. These can have adverse maternal and fetal outcome if left untreated. Hence a routine prenatal screening for mental illness and nonjudgmental and individualized care delivered by a multi-disciplinary team is critical for successful treatment and outcome.
