Obsessive-compulsive disorder in pregnancy and the postpartum period: course of illness and obstetrical outcome

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• 作者：Samuel J. House ; Shanti P. Tripathi ; Bettina T. Knight…
• 关键词：Obsessive ; compulsive disorder ; Course of illness ; Neonatal outcomes ; Obstetrical outcomes
• 刊名：Archives of Women's Mental Health
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：19
• 期：1
• 页码：3-10
• 全文大小：353 KB
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• 作者单位：Samuel J. House (1)
  Shanti P. Tripathi (1)
  Bettina T. Knight (1)
  Natalie Morris (1)
  D. Jeffrey Newport (2)
  Zachary N. Stowe (1)
  
  1. Department of Psychiatry, University of Arkansas for Medical Sciences, 4301 W. Markham, Box 843, Little Rock, AR, 72205, USA
  2. Departments of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology, University of Miami Miller School of Medicine, Miami, FL, USA
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Psychiatry
  Psychotherapy
  
• 出版者：Springer Wien
• ISSN：1435-1102

文摘

The study aimed to examine the course of obsessive-compulsive disorder (OCD) across pregnancy and its impact on obstetric and neonatal outcomes. Women enrolled prior to 20-week gestation in a prospective, observational study. The Structured Clinical Interview for DSM-IV was completed to obtain lifetime Axis I diagnoses. A total of 56 women with OCD were followed at 1 to 3-month intervals through 52 weeks postpartum. Each visit, the Yale-Brown Obsessive Compulsive Scale (YBOCS), clinical assessment, and medication/exposure tracking were performed. Obstetric and neonatal data were abstracted from the medical record. In subjects with OCD, associations between perinatal obsessive-compulsive symptoms (OCSs) and outcomes were examined. Additionally, outcomes were compared to 156 matched psychiatric patients without OCD. Maternal age inversely correlated with the YBOCS scores across the study period (β = −0.5161, p = .0378). Cesarean section was associated with increased OCSs in the postpartum period compared to vaginal delivery (β = 5.3632, p = 0.043). No associations were found between severity of perinatal obsessions or compulsions and any specific obstetric or neonatal complications. Subjects without OCD had higher frequency of fetal loss compared to mothers with OCD (χ 2 = 4.03, p = 0.043). These novel prospective data fail to identify an association of OCSs with adverse outcomes. In contrast, there is an association of delivery method and younger maternal age with increased postnatal symptoms of OCD. Psychiatric subjects without OCD may have a higher risk of miscarriage and intrauterine fetal demise compared to subjects with OCD. Keywords Obsessive-compulsive disorder Course of illness Neonatal outcomes Obstetrical outcomes