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Psychiatric and Substance Use Disorders as Risk Factors for Low Birth Weight and Preterm Delivery

From the Departments of Psychiatry, Epidemiology, and Obstetrics, University of Washington, Seattle, Washington; and Health Information Solutions, Menlo Park, California.

Address reprint requests to: Rosemary H. Kelly, MD, Department of Psychiatry and Behavioral Sciences, University of Washington Medical Center, Box 356560, 1959 NE Pacific Street, Seattle, WA 98195-6560; E-mail: rhkelly{at}u.washington.edu.

OBJECTIVE: We examined the associations between psychiatric and substance use diagnoses and low birth weight (LBW), very low birth weight (VLBW), and preterm delivery among all women delivering in California hospitals during 1995.

METHODS: This population-based retrospective cohort analysis used linked hospital discharge and birth certificate data for 521,490 deliveries. Logistic regression analyses were conducted to assess the associations between maternal psychiatric and substance use hospital discharge diagnoses and LBW, VLBW, and preterm delivery while controlling for maternal demographic and medical characteristics.

RESULTS: Women with psychiatric diagnoses had a significantly higher risk of LBW (adjusted odds ratio [OR] 2.0; 95% confidence interval [CI] 1.7, 2.3), VLBW (OR 2.9; 95% CI 2.1, 3.9), and preterm delivery (OR 1.6; 95% CI 1.4, 1.9) compared with women without those diagnoses. Substance use diagnoses were also associated with higher risk of LBW (OR 3.7; 95% CI 3.4, 4.0), VLBW (OR 2.8; 95% CI 2.3, 3.3), and preterm delivery (OR 2.4; 95% CI 2.3, 2.6).

CONCLUSION: Maternal psychiatric and substance use diagnoses were independently associated with low birth weight and preterm delivery in the population of women delivering in California in 1995. Identifying pregnant women with current psychiatric disorders and increased monitoring for preterm and low birth weight delivery among this population may be indicated.

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