Women who had contact with mental health services prior to their pregnancy are at greater risk of preterm birth by 50 per cent, research suggests.
A study funded by the National Institute for Health Research found that women who had used mental health services at least once in the seven years prior to their pregnancy were more at risk of preterm birth, as well as giving birth to a baby that was small for its gestational age.
In the largest study of its kind, researchers from King’s College London, the University of Exeter, the London School of Hygiene and Tropical Medicine and the University of Liverpool analysed the records of more than two million pregnant mothers between 2014 and 2018.
Of the women whose records were analysed, 7.3% (151,770) had at least one contact with mental health services in the seven years before pregnancy.
Women with psychiatric hospital admissions and women with more recent pre-pregnancy mental healthcare contacts were at the highest risk of birth-related consequences, the researchers found.
Study senior co-author, Professor Heather O’Mahen of the University of Exeter, said that the relation between obstetric and neonatal risk and mental health problems in the mother was known, but that ‘this research has practical implications’.
Professor O’Mahen said that the research would help to guide and focus clinician attention to women who may have had contact with mental health services in the last year or who may have a history of hospital admissions.
‘The NHS has invested significant funds in the past 10 years in perinatal mental health, and these findings support the continued health and mental health implications of providing women and birthing persons with timely and needed treatment and support,’ she said.
The research also found that more serious and recent mental health contacts were associated with greater risks of adverse consequences.
In women without a pre-pregnancy specialist mental health care, the risk of a preterm birth was 6.5%.
This increased to 9.2% among women who had a community care contact only, to 11% among women with a crisis resolution team, and to 13.4% in women with a psychiatric hospital admission.
A similar pattern was found in the risk of a baby being born small for gestational age (SGA).
The risk of a baby being born SGA increased from 6.2% among women with no contact with mental health services, to 9.5% among women who had been admitted to a psychiatric hospital.
Mothers whose contact had been within a year of birth were also more at risk than those whose contact with mental health services was longer ago.
Study senior co-author Jan van der Meulen, professor of clinical epidemiology from the London School of Hygiene and Tropical Medicine, said that the study ‘demonstrates the value of linking NHS datasets.’
‘As healthcare continues to evolve, evidence-based decision-making becomes increasingly crucial,’ Professor van der Meulen added.
‘By prioritising mental health during pregnancy and childbirth, healthcare professionals can optimise care and support for women, ensuring healthier outcomes for both mother and child.’