Published: 15 August 2023
A study analysing data from over two million pregnant women has found that women who had at least one contact with mental health services in the seven years prior to their pregnancy were at increased risk of preterm birth.
In women who had used mental health services before their pregnancy, one in ten had a preterm birth compared to one in 15 in those who had not. They were also found be at a higher risk of giving birth to a baby that was small for its gestational age - increasing from 65 per 1000 births in women who had not used mental health services to 75 per 1000 birth in women who had.
Better identification of women in need
The team, led by researchers at the University of Exeter, King’s College London and the London School of Hygiene and Tropical Medicine, with involvement from St George’s, conclude that information about contacts with mental healthcare before pregnancy can help to identify women who are most likely to benefit from working with community perinatal mental health teams in coordination with local maternity services.
Previous research has identified a link between poor mental health in pregnant mothers and worse outcomes for babies. However, the new research, which linked hospital and birth registration data with specialist mental health service records for the largest study of its kind, quantifies the effects in greater detail.
In more than two million pregnant mothers who gave birth to a single child between 2014 and 2018, 7.3 per cent (151,770) had at least one contact with mental health services in the seven years before their pregnancy. Women with psychiatric hospital admissions and women with more recent pre-pregnancy mental healthcare contacts were at the highest risk of birth-related complications.
Integrated care
“This study shows that pregnant women with mental illness have an increased chance of premature birth, having a small baby, and their babies having health problems in the first month after birth. Midwives and obstetricians could use knowledge of the timing and level of pre-pregnancy specialist mental healthcare contacts to identify those most likely to benefit from integrated perinatal mental health and obstetric care, and reduce their risk of adverse pregnancy outcomes.”
- Professor Asma Khalil, Professor of Obstetrics and Maternal Fetal Medicine at St George's and co-author of the study -
Study senior co-author Professor Heather O'Mahen from the University of Exeter, said: " The NHS has invested significant funds in the past 10 years in perinatal mental health, and these findings support the continued health and mental health implications of providing women and birthing persons with timely and needed treatment and support.”
Study senior co-author Jan van der Meulen, professor of clinical epidemiology from the London School of Hygiene and Tropical Medicine, said: “This study demonstrates the value of linking NHS datasets. Improving the accuracy and completeness of national data on mental health services and maternity care is a key priority. NHS England should improve access to up-to-date data so that research can guide and monitor initiatives to improve perinatal mental health services.”
The study was published in The Lancet Psychiatry.
Find out more about our research at the Institute for Molecular and Clinical Sciences