Adverse pregnancy outcome in schizophrenic women: occurrence and risk factors

Low birth weight and preterm birth are important predictors of infant mortality and morbidity, and may increase the risk of schizophrenia. These adverse outcomes of pregnancy could be associated, therefore, with increased risk in children genetically predisposed to schizophrenia. The aim of this review was to describe the occurrence of risk factors for low birth weight, preterm birth, and perinatal death among schizophrenic women, and to describe the incidence of those adverse pregnancy outcomes among schizophrenic women. Smoking, substance abuse, and low socioeconomic status are associated with fetal growth retardation, preterm birth, and perinatal death, and also with schizophrenia. Therefore, increased incidence of adverse pregnancy outcome should be expected in schizophrenic women. The available evidence suggests that schizophrenic women are at increased risk of delivering infants with low birth weight, but the existing studies are of small statistical power. Preterm birth and perinatal death have only been investigated little among schizophrenic women. An important focus of future research should be to establish the risk of adverse pregnancy outcome, and to study the association between the suspected risk factors and pregnancy outcome in schizophrenic women. In clinical work with pregnant schizophrenic women, efforts should be made to prevent exposure to suspected risk factors like smoking, substance use, and socioeconomic problems. This could possibly decrease the mortality and morbidity, including the risk of schizophrenia in the offspring, and clarify the importance of environmental and genetic factors in the etiology of schizophrenia. (C) 1998 Elsevier Science B.V. All rights reserved.