Pregnancy and postpartum specifics in women with schizophrenia: a meta-study.

OBJECTIVE

This meta-study intends to elucidate schizophrenia-pregnancy inferences.

METHODS

A total of 63 quasi-randomized, case-control, linkage studies on outcomes of singleton pregnancies in women with schizophrenia are identified through PubMed, ACOG, and SCOPUS. A sample of 216 pregnant and puerperal women with schizophrenia, allocated from studies of level I-IIA evidence, is compared with a sample of 487 births to unaffected women. Calculations use births as unit of analysis. Poisson regression model is used in exchangeable correlation structure.

RESULTS

Older age (2.13), excessive smoking (1.85) and less antenatal care (1.92) in women with schizophrenia determine high risk for prematurity (2.08), including miscarriages (2.04) and preterm birth (1.98). Neonates to mothers with schizophrenia are profiled with twice likelihood of low Apgar scores (2.22), intrauterine growth retardation (2.16), and congenital defects (2.1). Poor maternal-fetal attachment and preoccupation about fetus are related to negative symptoms of schizophrenia (-0.518), length of antipsychotic treatment (-0.304) and are not associated with maternal age (0.216). Postpartum period is eventful with psychotic relapse (7.86), and parenting difficulties (11.2).

CONCLUSIONS

After adjusting for age, parity, unhealthy behaviors, length of antipsychotic treatment, and maternal-fetal attachment, maternal schizophrenia remains predictive to prematurity and postpartum psychosis.