Risk of adverse pregnancy, neonatal outcomes up with maternal OCD

Women with obsessive-compulsive disorder (OCD) have increased risk of adverse pregnancy, delivery, and neonatal outcomes, according to a study published online June 14 in JAMA Network Open.

Lorena Fernández de la Cruz, Ph.D., from the Karolinska Institutet in Stockholm, and colleagues examined the associations of maternal OCD with pregnancy, delivery, and neonatal outcomes in two studies. In the Swedish cohort, 8,312 pregnancies in women with OCD were compared with 2,137,348 pregnancies in unexposed women, while in the cohort from British Columbia (BC), Canada, 2,341 pregnancies in women with OCD were compared with 821,759 pregnancies in unexposed women.

The researchers found that maternal OCD was associated with increased risks of gestational diabetes, elective cesarean delivery, preeclampsia, induction of labor, emergency cesarean delivery, and postpartum hemorrhage in the Swedish cohort (adjusted risk ratios [aRRs], 1.40, 1.39, 1.14, 1.12, 1.16, and 1.13, respectively). In the BC cohort, significantly higher risk was seen for emergency cesarean delivery and antepartum hemorrhage or placental abruption (aRR, 1.15 and 1.48, respectively). In both cohorts, offspring of women with OCD had increased risk of low Apgar score at 5 minutes (aRRs, 1.62 and 2.30 in Sweden and BC, respectively), preterm birth (aRRs, 1.33 and 1.58, respectively), low birth weight (aRRs, 1.28 and 1.40, respectively), and neonatal respiratory distress (aRRs, 1.63 and 1.47, respectively). The risk of these outcomes was increased for women with OCD taking serotonin reuptake inhibitors during pregnancy.

"Improved collaboration between psychiatry and obstetric services, as well as improved maternal and neonatal care for women with OCD and their children, is warranted," the authors write.

Two authors disclosed ties to the publishing and medical technology industries.

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