Joseph Ben-Sheetrit1, Liat Huller-Harari2, Michal Rasner2, Nehemia Magen3, Nitsa Nacasch2, Paz Toren4. 1. Tel-Aviv Brüll Community Mental Health Center, Clalit Health Services, Tel-Aviv, Israel; Geha Mental Health Center, Petah Tikva, Israel. Electronic address: joseph.ben.sheetrit@gmail.com. 2. Tel-Aviv Brüll Community Mental Health Center, Clalit Health Services, Tel-Aviv, Israel. 3. Clalit Health Services, Tel-Aviv, Israel. 4. Tel-Aviv Brüll Community Mental Health Center, Clalit Health Services, Tel-Aviv, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Abstract
BACKGROUND: Inadequate prenatal care has been associated with adverse perinatal outcomes. We sought to compare compliance with prenatal care visits (PCV), oral glucose tolerance test (OGTT) and serum alfa-fetoprotein (aFP) in women with psychiatric disorders (PD) and healthy controls. METHODS: Subjects were 5395 women (1043 PD and 4352 controls), members of Clalit Health Services (Tel-Aviv district, Israel), who gave birth during 2004-2014. We used Generalized Estimating Equations with binary-logistic models, considering consecutive pregnancies as repeated measures with unbalanced design. The diagnostic subgroup was the main independent, assessed once with and once without age, socioeconomic status and multiple gestation variables. RESULTS: Risk for non-compliance with OGTT was increased in women with depression (aOR = 1.4, 95% CI = 1.1-1.7) and schizophrenia (aOR = 1.8, 95% CI = 1.1-2.9), but not anxiety. Risk for non-compliance with aFP was decreased in women with anxiety (aOR = 0.6, 95% CI = 0.5-0.8), but women with depression and schizophrenia did not differ from controls. PD were at risk for both absence of PCV (aOR = 4.6, 95% CI = 2.7-8.0) and high utilization of PCV (>20 visits, aOR = 2.8, 95% CI = 2.1-3.7). Psychopharmacological treatment during pregnancy was associated with high utilization of PCV (OR = 2.2, 95% CI = 1.7-2.9), increased compliance with aFP tests (OR = 1.4, 95% CI = 1.1-1.7) and marginally-significant increased compliance with OGTT (OR = 0.82, 95% CI = 0.67-1.01). CONCLUSION: PD under-utilized tests perceived for the wellbeing of the mother (OGTT) and over-utilize tests for the wellbeing of the fetus (aFP). PD exhibited patterns of both very low and very high utilization of PCV. Psychopharmacological treatment during pregnancy may improve some measures of compliance with prenatal care.
BACKGROUND: Inadequate prenatal care has been associated with adverse perinatal outcomes. We sought to compare compliance with prenatal care visits (PCV), oral glucose tolerance test (OGTT) and serum alfa-fetoprotein (aFP) in women with psychiatric disorders (PD) and healthy controls. METHODS: Subjects were 5395 women (1043 PD and 4352 controls), members of Clalit Health Services (Tel-Aviv district, Israel), who gave birth during 2004-2014. We used Generalized Estimating Equations with binary-logistic models, considering consecutive pregnancies as repeated measures with unbalanced design. The diagnostic subgroup was the main independent, assessed once with and once without age, socioeconomic status and multiple gestation variables. RESULTS: Risk for non-compliance with OGTT was increased in women with depression (aOR = 1.4, 95% CI = 1.1-1.7) and schizophrenia (aOR = 1.8, 95% CI = 1.1-2.9), but not anxiety. Risk for non-compliance with aFP was decreased in women with anxiety (aOR = 0.6, 95% CI = 0.5-0.8), but women with depression and schizophrenia did not differ from controls. PD were at risk for both absence of PCV (aOR = 4.6, 95% CI = 2.7-8.0) and high utilization of PCV (>20 visits, aOR = 2.8, 95% CI = 2.1-3.7). Psychopharmacological treatment during pregnancy was associated with high utilization of PCV (OR = 2.2, 95% CI = 1.7-2.9), increased compliance with aFP tests (OR = 1.4, 95% CI = 1.1-1.7) and marginally-significant increased compliance with OGTT (OR = 0.82, 95% CI = 0.67-1.01). CONCLUSION:PD under-utilized tests perceived for the wellbeing of the mother (OGTT) and over-utilize tests for the wellbeing of the fetus (aFP). PD exhibited patterns of both very low and very high utilization of PCV. Psychopharmacological treatment during pregnancy may improve some measures of compliance with prenatal care.
Authors: Akilew A Adane; Helen D Bailey; Vera A Morgan; Megan Galbally; Brad M Farrant; Rhonda Marriott; Scott W White; Carrington Cj Shepherd Journal: Arch Womens Ment Health Date: 2021-01-02 Impact factor: 3.633