[Influence of maternal neuropsychiatric disorders on clinical course of pregnancy and neonatal outcome].

Abstract

The obstetric course and neonatal outcome were studied in 35 pregnant women with neuropsychiatric disorders who were admitted to Toho University Ohmori Hospital between 1981 and 1990. The rate of live births associated with psychiatric disease was 0.49% (40 of 8.191 deliveries). These were schizophrenia (N = 17), epilepsy (N = 12), depression (N = 2), neurosis (N = 3) and psychogenic response (N = 1). Iron deficiency anemia was observed in 8 of 16 epileptic women. Cesarean section or vacuum extraction were performed in 15 of 40 cases (37.5%). The indications for these procedures were uncontrollable psychotic symptoms in all of 6 schizophrenic women, while those in all 7 epileptic women were obstetrical. Symptoms of schizophrenia became worse in 33.3% and 50% of the patients during and after birth, respectively. The incidence of preterm delivery was 15%, and 25% of newborn infants were of low birthweight. Drug withdrawal symptoms were observed in 4 of 16 infants (25%) born to epileptic mothers. Three of 10 offspring of epileptic mothers were affected by febrile convulsions within 6 years of age. Although a relatively higher incidence of obstetric complications has recognized, there seem to be no specific complications in epileptic or psychiatric women. Our results also suggest the importance and need for close cooperation between the obstetrician and psychiatrist, and a follow-up program for offspring.