Maternal OCD Linked to Pregnancy and Delivery Outcomes

Obsessive-compulsive disorder (OCD) is a psychiatric disorder that affects a significant portion of the population, with estimates ranging from 1% to 3%. It is believed to be more prevalent in women, with a 1.6 times higher likelihood compared to men.

OCD is associated with various health-related issues, but its impact on pregnancy and neonatal outcomes has been understudied and poorly understood. Previous studies examining these outcomes in women with OCD have been limited in sample size or lacked appropriate comparison groups, hindering our understanding of the true effects.  

As per JAMA, the use of medication, particularly serotonin reuptake inhibitors (SSRIs), in the management of OCD symptoms is common in Sweden. However, the potential association between SRI use during pregnancy and perinatal and neonatal outcomes has not been thoroughly investigated.

This is particularly important because previous research has linked selective serotonin reuptake inhibitors (SSRIs) with adverse pregnancy and neonatal outcomes. Additionally, the influence of shared familial factors, which could confound the association between maternal OCD and pregnancy-related outcomes, has not been adequately explored.  

A recent population-based research done in Sweden and British Columbia, Canada, sheds fresh light on the difficulties experienced by moms with OCD during pregnancy, as well as the consequences the disorder has on their children. The study discovered that OCD mothers were more likely to have infants with birth abnormalities and other issues.

This set of problems included gestational diabetes, hypertension, antepartum hemorrhage/placental abruption, induction of labor, elective/emergency cesarean delivery, postpartum hemorrhage, and placental abruption. Furthermore, their babies were more likely to have preterm, low birth weight, a low 5-minute Apgar score, newborn hypoglycemia, neonatal respiratory distress, neonatal infections, and low birth weight.  

These findings are consistent with prior studies indicating that OCD women are at a higher risk of problems during pregnancy. Furthermore, the study looked into serotonin reuptake inhibitors (SRIs), which are commonly used to treat OCD symptoms. Pregnant women with OCD who used SRIs were more likely to have a worse outcome than pregnant women with OCD who did not use SRIs.

This was true despite large differences in SRI prescription rates among cohorts (37.2% in Sweden vs. 81.0% in British Columbia). However, caution is advised when interpreting these data due to the possibility of a confounding factor related to indication. This is because SRIs may produce more severe symptoms of the condition in women.  

Furthermore, studies of OCD mothers and their siblings or cousins were included to investigate the relevance of shared family variables in the reported relationships between maternal OCD and pregnancy outcomes. Although the majority of the correlations were not statistically significant in these analyses, maternal OCD was substantially connected to outcomes such as a low Apgar score and child respiratory distress. This suggests that these risks may be unrelated to either genetics or the environment.  

These findings have far-reaching implications for both public health and therapeutic practice. The findings of this study emphasize the importance of improved communication between psychiatric and obstetric hospitals in order to provide comprehensive care for pregnant women with OCD. Because of the potential impact of SRI usage on the links between maternal OCD, poor maternal and newborn outcomes, and close monitoring of pregnant women with OCD, extra attention should be paid to neonatal care.  

More study is needed to understand the exact links between different types and doses of SRI medications and outcomes in pregnant women with OCD, as these findings imply. Studies on family coaggregation and putative causal variables are needed to better understand the processes responsible for the observed associations.

According to the findings of this study, healthcare practitioners and the general public need to understand more about OCD in pregnant women in order to give the best possible care for the mother and her child.