The impact of obesity on pregnancy outcomes among women with psychiatric disorders: Results from a prospective pregnancy registry

J Psychosom Res. 2019 Aug;123:109735. doi: 10.1016/j.jpsychores.2019.109735. Epub 2019 Jun 4.

Abstract

Objective: Obesity is associated with an increased risk of adverse pregnancy outcomes. As individuals with psychiatric disorders are at a higher risk of obesity than the general population, we aimed to examine the effect of obesity on neonatal and maternal outcomes in this population.

Methods: Pregnant women with psychiatric disorders were enrolled in the Massachusetts General Hospital National Pregnancy Registry for Psychiatric Medications (NCT01246765) and followed prospectively until 6 months postpartum. Pre-pregnancy body mass index was used to categorize participants as normal-weight, overweight, and obese to assess comparative risk of adverse outcomes.

Results: Within our sample of 584 participants (N = 252 normal-weight; N = 170 overweight; N = 162 obese), obesity was not significantly associated with higher risk for birth defects (OR: 3.19; 95% CI:0.79,12.95; p = 0.10; unadjusted due to the rarity of this outcome in the sample). After adjustment, women with obesity were at higher risk for gestational diabetes (p = 0.011; OR:3.23; 95% CI:1.30,7.98), as were women in the overweight BMI category (p = 0.003; OR:3.77; 95% CI:1.58,9.00). Among women with obesity, there was a tendency for a higher C-section rate (p = 0.07) compared to women in the normal-weight BMI category. Other outcomes were not significantly different among groups.

Conclusions: Peripartum complications associated with obesity are common among women with psychiatric illness; thus, it is important to develop antenatal weight management interventions for this population.

Keywords: Congenital malformation; Gestational diabetes; Obesity; Pregnancy; Psychiatric disorder; Psychopharmacology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Humans
  • Middle Aged
  • Obesity / complications*
  • Pregnancy
  • Pregnancy Complications / etiology*
  • Pregnancy Complications / psychology
  • Pregnancy Outcome / epidemiology*
  • Prospective Studies
  • Psychotic Disorders / etiology*
  • Psychotic Disorders / psychology
  • Registries
  • Young Adult