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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (4): 576-578    DOI: 10.31083/j.ceog.2020.04.5303
Original Research Previous articles | Next articles
Risk factors of self-interruption of medications for mental disorders in pregnancy
J. Ogawa1, S. Suzuki1, *()
1Department of Obstetrics and Gynecology, Japanese Red Cross Katsushika Maternity Hospital, Tokyo, Japan
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Abstract  

The current study examined factors associated with the increased risk of self-interruption of medications for mental disorders in pregnancy. We reviewed the obstetric records of all singleton deliveries beyond 22 weeks of gestation at Japanese Red Cross Katsushika Maternity Hospital form January 2014 through July 2018. We examined the clinical and social characteristics and obstetric outcomes in women with self-interruption of medications for mental disorders in pregnancy in comparison with those in women who continued the medications throughout the pregnancy. There were 177 women who were diagnosed with mental disorders requiring medications before pregnancy by Japanese psychiatric specialists. Of these, 46 (26%) self-interruptedi their medications during the first trimester of their pregnancies. The rates of partners with mental disorders (odds ratio: 4.39, p = 0.01) and presence of social support (odds ratio: 2.50, p = 0.02) in women showing self-interruption of their medications were significantly higher than those in women continuing the medications. In the presence of both factors of a partner's mental disorders and social support, the odds ratio for self-interruption of medications increased to 15.9 (95% confidence interval 2.4-100, p < 0.01). We believe that it may be the possible to identify women at high risk of self-interruption of medications during pregnancy. In women requiring perinatal mental health care, mental health support of their partners may also be needed.

Key words:  Risk factors      Self-interruption of medications      Mental disorders      Pregnancy     
Submitted:  12 July 2019      Accepted:  23 September 2019      Published:  15 August 2020     
*Corresponding Author(s):  S. Suzuki     E-mail:  czg83542@mopera.ne.jp

Cite this article: 

J. Ogawa, S. Suzuki. Risk factors of self-interruption of medications for mental disorders in pregnancy. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(4): 576-578.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.04.5303     OR     https://ceog.imrpress.com/EN/Y2020/V47/I4/576

Table 1  — Clinical and social characteristics in the pregnant women with mental disorders with and without self-interruption of their medications.
No Yes p-value Odds ratio 95% CI
Total 131 46
Diagnosis
Depression 54 (41) 18 (39) 0.86 0.917 0.46-1.8
Anxiety disorder 46 (35) 15 (33) 0.86 0.894 0.44-1.8
Schizophrenia 14 (11) 2 (4) 0.25 0.380 0.093-1.6
Bipolar disorders 10 (8) 5 (11) 0.54 1.48 0.50-4.4
Others 7 (5) 6 (13) 0.10 2.66 0.88-8.0
Nullioarity 94 (72) 28 '61) 0.20 0.629 0.31-1.3
Maternal age
< 20 3 (2) 1 (2) 1.00 0.906 0.13-6.6
20-34 87 (67) 32 (70) Reference 1 -
≤ 35 41 (31) 13 (28) 0.85 0.862 0.41-1.8
Twin pregnancy 4 (3) 2 (4) 0.65 1.44 0.30-7.0
History of infertility treatment 14 (11) 1 (2) 0.12 0.186 0.031-1.1
Mental disorders in the paetner 6 (6) 8 (17) 0.01 4.39 1.5-13
Presence of social support 23 (18) 16 (35) 0.02 2.50 1.2-5.3
Table 2  — Psychiatric and obstetric outcomes in pregnant women with and without self-interruption of medications for mental disorders in pregnancy.
No Yes p-value Odds ratio 95% CI
Total 131 46
Deterioration / relapse 23 (18) 22 (48) < 0.01 4.30 2.1-8.9
Preterm delivery 8 (6) 7 (15) 0.07 2.76 0.98-7.8
Delivery mode
Normal delivery 80 (61) 18 (39) Reference 1 -
Vacuumextraxtion 11 (8) 7 (15) 0.07 2.83 0.99-8.1
Cesarean section 40 (31) 21 (46) 0.04 2.33 1.1-4.8
Low birthweight infant 20 (15) 13 (28) 0.08 2.19 1.0-4.8
Neonalat asphyxia 1 (1) 3 (7) 0.05 9.07 1.3-65
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