Association between affective disorders presenting before and during pregnancy and pre-term birth, considering socio-demographic factors, obstetric factors, health conditions, and use of medication

OBJECTIVE: To study the relationship between maternal affective disorders (AD) before and during pregnancy, and pre-term birth. DESIGN: Retrospective observational study. LOCATION: Sexual and reproductive health units at the Institut Català de la Salut (ICS) in Catalonia, Spain. PARTICIPANTS: Pregnant women with a result of live-born child from 1/1/2012 to 30/10/2015. INTERVENTIONS: Data were obtained from the ICS Primary Care electronic medical record. MAIN MEASUREMENTS: Diagnosis of AD before and during pregnancy, months of pregnancy, and possible confusion factors were collected. Descriptive statistical analysis (median, interquartile range, and absolute and relative frequency), bivariate analysis (Wilcoxon test and Chi-square test), and multivariate analysis (logistic regression) were performed. RESULTS: 102,086 women presented valid information for the study. Prevalence of AD during pregnancy was 3.5% (4.29% in pre-term and 3.46% in term births; p < 0.004). Pregnant women with pre-term births presented a higher age, smoking habit, lower inter-pregnancy interval, and a lower socio-economic status. Pre-term birth was significantly associated to previous history of stress and dissociative disorder (SDD), anxiety, obsessive-compulsive disorder (OCD) and eating disorders (ED), and use of antidepressants. It was also associated to abuse of alcohol, smoking, and use of psychoactive substances, as well as SDD, ED, use of antipsychotics, and divorce during pregnancy. Multivariate analysis confirmed the relationship between pre-term birth and history of AD, SDD, ED, and smoking, but not with AD during pregnancy. CONCLUSIONS: Examining the previous history of SDD and ED in pregnant women, and SDD, and ED during pregnancy is highly relevant to avoid pre-term birth.