Obstetric complications in bipolar disorder: The role of mental health disorders in the risk of caesarean section

J Affect Disord. 2019 Jun 1:252:458-463. doi: 10.1016/j.jad.2019.04.017. Epub 2019 Apr 8.

Abstract

Background: Women with Bipolar Disorder (BD) during pregnancy present a negative impact on them and their babies' health. Caesarean Section (C-Section) is an intervention to reduce complications associated with childbirth, but it also has risks, including maternal infections, anaesthetic and psychological complications. There are few studies that analyse the C-Section rates in women with BD compared to the general population.

Methods: A case-control study was conducted in a general university hospital. 100 pregnant women with BD matched with 100 controls without psychiatric illness who were attending the same hospital at delivery. We compared obstetrical outcomes during pregnancy, Pre/During Labour, onset of labour and mode of delivery specifying the type of C-Section.

Results: Rate of C-Section was significantly higher in BD group compared to the control group (OR=2, 95% CI 1,4-1,6). Case group had more somatic illness (SI) without treatment (P<, 001). BD (P=,021), primiparity (P=, 003), obstetric complications during pregnancy (P<, 001), obstetric complications during labour (P<,001), and SI with and without treatment (P<,001 and P=,007, respectively) were higher in women that required C- section.

Conclusion: Women with Bipolar Disorder have near two-fold increased risk of C-section than women without Bipolar Disorder of similar age, gestational age and parity. Somatic illness was more prevalent in BD group that required C-section and this relation probably is related to high probability of having somatic comorbidities in patients with BD.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Bipolar Disorder / complications*
  • Case-Control Studies
  • Cesarean Section / psychology
  • Cesarean Section / statistics & numerical data*
  • Female
  • Gestational Age
  • Humans
  • Parity
  • Pregnancy
  • Pregnancy Complications / psychology*
  • Pregnancy Complications / surgery*
  • Risk Factors
  • Young Adult