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

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

Author information

1
Massachusetts General Hospital, Ammon-Pinizzotto Center for Women's Mental Health, 185 Cambridge Street, Suite 2200, Boston, MA 02114, USA. Electronic address: mfreeman@partners.org.
2
Massachusetts General Hospital, Ammon-Pinizzotto Center for Women's Mental Health, 185 Cambridge Street, Suite 2200, Boston, MA 02114, USA.
3
Massachusetts General Hospital, Ammon-Pinizzotto Center for Women's Mental Health, 185 Cambridge Street, Suite 2200, Boston, MA 02114, USA; Cleveland Clinic, Cleveland Clinic Neurological Institute, 9500 Euclid Avenue, Cleveland, OH 44195, USA.

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

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