Obsessive-compulsive disorder in pregnancy and the postpartum period: course of illness and obstetrical outcome.
Obsessive-compulsive disorder in pregnancy and the postpartum period: course of illness and obstetrical outcome.
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DOI：
10.1007/s00737-015-0542-z
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发表时间：
2016-02
期刊：
影响因子：
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通讯作者：
Stowe ZN
中科院分区：
文献类型：
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作者：
House SJ;Tripathi SP;Knight BT;Morris N;Newport DJ;Stowe ZN
To examine the course of obsessive-compulsive disorder (OCD) across pregnancy and its impact on obstetric and neonatal outcomes. Women enrolled prior to 20 weeks 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 was performed. Obstetric and neonatal data was abstracted from the medical record. In subjects with OCD, associations between perinatal obsessive-compulsive symptoms (OCS) 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). Caesarean section was associated with increased OCS 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 with any specific obstetric or neonatal complications. Subjects without OCD had higher frequency of fetal loss compared to mothers with OCD (χ² = 4.03, p = 0.043). These novel prospective data fail to identify an association of OCS 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.
