Birth Outcomes after Maternal Use of Medications for Mental Health Illnesses During Pregnancy

Purpose The use of medications for mental health illnesses (MHI) has increased in prevalence, particularly for women of childbearing age. Recent investigations into the use of such medications during pregnancy have had inconsistent results. The purpose of this study is to examine the association between maternal use of medications for MHI during pregnancy and risk of select birth outcomes using data from the Pregnancy Risk Assessment Monitoring System (PRAMS). Methods PRAMS is a population-based survey of women who delivered live-born infants. Michigan asked state-specific questions regarding the use of medication for MHI during pregnancy from 2000–2003. Complete information on key variables was available for 3,793 women. Logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs) to model the association between the use of medications for MHI and birth outcomes (specifically, low birth weight [defined as <2,500 grams] and preterm delivery [defined as <37 weeks]). Potential confounding factors that altered the medication use-birth outcome OR estimates by ≥10% were included in the final logistic models. Results Women who reported using medications for MHI during pregnancy had a slight increased risk of delivering a low birth weight baby after adjustment for race/ethnicity and hypertensive disorders during pregnancy (OR=1.14; 95% CI: 0.71, 1.84). The association between medication use for MHI and preterm delivery was similar after adjustment for the same confounding factors (OR=1.13; 95% CI: 0.61, 2.07). Conclusion In this study, the use of medication for MHI was associated with slight increased risks of low birth weight and preterm delivery; however, these risks were not statistically significant. Women who discontinue the use of these medications may risk a relapse of their illness. Women and healthcare professionals need to discuss the risks and benefits of using medications for MHI during preconception and prenatal care counseling sessions in order to make personalized decisions as to whether to continue their use during pregnancy.