2026 ECNP Congress

PS02-2181

Impact of pre-existing mental health conditions on obstetric and neonatal outcomes

Tiziano Prodi — C. Singh Solorzano, B. Dell'Osso, A. Cattaneo · University of Milan, Department of Pharmacological and Biomolecular Sciences, Milano, Italy

2026 ECNP Congress

Perinatal mental health conditions are associated with an increased risk of adverse obstetric and neonatal outcomes [1]. However, they remain underdiagnosed and undertreated, resulting in detrimental consequences for women, their offspring, and the broader family system [2-4]. This study aimed to investigate whether pregnant women with a pre-existing mental health condition - including Schizophrenia Spectrum Disorders (SSD), Bipolar and Related Disorders (BRD), Depressive Disorders (DD), Anxiety Disorders (AD), Obsessive-Compulsive and Related Disorders (OCRD), Trauma- and Stressor-Related Disorders (TSRD), and Borderline Personality Disorder (BPD) - show an increased risk of obstetric and neonatal complications compared with women without mental health disorders.

This retrospective study was conducted using data from a regional administrative database in Lombardy, Italy, ranging between years 2013 and 2023. Pregnant women with pre-existing mental health conditions were identified through ICD-9 codes mapped onto current diagnostic categories. For each diagnostic group, women were compared with a matched control subsample drawn from a pool of women without recorded mental health disorders. Matching variables included age, education level, parity, previous cesarean delivery, and multiple pregnancy. Obstetric and neonatal outcomes were assessed, including delivery characteristics, perinatal care indicators, and neonatal parameters. Analyses were conducted separately for each diagnostic group versus its matched control subsample. Linear and logistic regression models were used for continuous and categorical outcomes, respectively. P-values were adjusted using the Benjamini–Hochberg false discovery rate method. Results are reported as Beta or odds ratio (OR) for continuous and categorical variables respectively, together with 95% confidence interval (CI). Statistical analyses were conducted using SAS v.9.2.

A total of 5,929 women with a pre-existing mental health condition were included. The control pool comprised 2,510 women without recorded mental health disorders, from which matched control subsamples were selected for the diagnostic-specific comparisons. Statistically significant results were reported for each mental health condition in Table 1.

Table 1. Statistical significant results.

VariableOR (95%CI) SSD (N=181) BRD (N=173) DD (N=961) AD (N=2,542) OCRD (N=142) TSRD (N=1,779) BPD (N=151)
I-II grade laceration 2.89 (1.75;4.77) 2.39 (1.44;3.97) 2.43 (1.94;3.04) 2.55 (2.23;2.92) 3.22 (1.77;5.86) 2.73 (2.32;3.20)
III-IV grade laceration 2.83 (1.41;5.68) 3.85 (1.42;10.41)
Labour induction 1.37 (1.20;1.57) 1.51 (1.29;1.78) 2.16 (1.21;3.86)
Absence of labour 2.16 (1.18;3.96) 1.56 (1.19;2.03) 1.43 (1.21;1.69) 1.45 (1.19;1.77) 3.73 (1.87;7.46)
Scheduled cesarean section 2.03 (1.22;3.38) 2.39 (1.29;4.41) 1.45 (1.10;1.91) 1.32 (1.12;1.57) 2.83 (1.41;5.69)
Blood loss (over than 1,000 mL) 3.64 (2.27;5.82)
Fetal growth restriction 2.03 (1.28;3.22) 1.41 (1.07;1.85)
Skin to skin contact 3.92 (2.44;6.28) 3.39 (2.05;5.62) 2.70 (2.18;3.35) 2.37 (2.08;2.69) 2.69 (1.57;4.60) 2.21 (1.89;2.58) 3.16 (1.82;5.46)
Breastfeeding after delivery 5.01 (3.08;8.15) 3.30 (2.00;5.47) 2.32 (1.87;2.88) 1.97 (1.73;2.24) 1.71 (1.46;2.00) 2.98 (1.72;5.17)

The conditions investigated were associated with an increased risk of delivery complications and a more medicalized childbirth. These findings highlight the need for tailored obstetric care in women with pre-existing psychiatric conditions and underline the possibility of a shared mechanism linking perinatal mental health conditions to obstetric and neonatal complications. Interestingly, the increased rates of skin-to-skin contact and breastfeeding observed in almost all groups may reflect greater clinical attention and support during the perinatal period.

References

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