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  • Title: Severe mental illness and induction of labour: outcomes for women at a specialist antenatal clinic in Western Australia.
    Author: Frayne J, Lewis L, Allen S, Hauck Y, Nguyen T.
    Journal: Aust N Z J Obstet Gynaecol; 2014 Apr; 54(2):132-7. PubMed ID: 24172035.
    Abstract:
    BACKGROUND: Limited evidence is available around induction of labour (IOL) and obstetric outcomes for pregnant women with severe mental illness (SMI). AIMS: Our study examined obstetric and neonatal outcomes for women attending a specialist childbirth and mental illness (CAMI) antenatal clinic in Perth, Western Australia (WA), who experienced or did not experience IOL. METHODS: A retrospective study was conducted between December 2007 and May 2012 (n = 222), using patient records and computerised perinatal data collected by the Obstetrics and Gynaecology Clinical Care Unit. Descriptive statistics and univariate comparisons using Mann-Whitney tests and X(2) tests were conducted using SPSS. RESULTS: The overall rate of IOL in this study group was 40%, which was significantly higher than the WA Mother Baby Statistics by 11.6% (95% CI 4.9-18.3%, P < 0.002). Of those induced, 30% (27 of 185) were induced for psychiatric reasons. Women with schizophrenia were more likely to have IOL for an obstetric/fetal reason than a psychiatric reason (45% vs. 15%, P = 0.051). Women who experienced an IOL were less likely to have a spontaneous vaginal delivery (SVD) and more likely to have an assisted vaginal birth or emergency caesarean section (P = 0.040). Irrespective of labour onset, special care nursery admission (SCN) rates were similar and high for both groups (36% vs. 32%, P = 0.599). CONCLUSION: Obstetric management for women with SMI is complex, and psychiatric factors as well as medical factors must be considered to ensure the best outcomes for mother and infant.
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