Medical outcome of pregnancy in women with psychotic disorders and their infants in the first year after birth

Background: There has been little research into the health of infants of women with psychotic disorders. Aims: To investigate the antenatal care of mothers with a history of psychotic disorders, obstetric outcomes and the subsequent health of their babies. Method: A matched, controlled cohort study was carried out using the General Practice Research Database. Women with a history of a psychotic disorder, who gave birth in 1996-1998, were compared with women matched for age and general practice (199 cases and 787 controls) and their infants. Results: Cases had a higher proportion of stillbirths (OR=4.03, 95% Cl 1.14-4.25, P=0.03) and neonatal deaths (P<0.001). There was no difference in gestational age at antenatal booking. Mothers with psychotic disorders were less likely than controls to attend for infant immunisations 90-270 days after birth (RR=0.94, 95% Cl 0.88-0.99, P=0.03). There was no significant difference in the rates of accidents and hospital contacts for infants. Conclusions: There is an increased risk of stillbirth and neonatal death in women with a history of psychotic disorder, and it is therefore important for health care professionals to focus on optimal obstetric care. The physical health of babies who live with mothers with psychotic disorders is not significantly different from that of matched baby controls.