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Severe mental illness and induction of labour: outcomes for women at a specialist antenatal clinic in Western Australia
Author(s) -
Frayne Jacqueline,
Lewis Lucy,
Allen Suzanna,
Hauck Yvonne,
Nguyen Thinh
Publication year - 2014
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.12143
Subject(s) - medicine , caesarean section , childbirth , vaginal delivery , mental illness , obstetrics and gynaecology , obstetrics , pregnancy , pediatrics , psychiatry , mental health , family medicine , genetics , biology
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.