{
  "abstract": "Objectives To synthesise evidence on the association between any diagnosed or self-reported mental health problems prior to pregnancy (pre-existing mental health problems) and birth outcomes including preterm birth (PTB), low birth weight (LBW), small for gestational age (SGA), neonatal unit (NNU) admission and mode of birth (instrumental birth, planned or unplanned caesarean section).Methods Systematic searches were conducted in MEDLINE, CINAHL, Embase and PsycINFO in December 2024 for studies examining the association between any pre-existing mental health problems and PTB, LBW, SGA, NNU admission and mode of birth. Only articles published in English were included with no restriction on year of publication. Two reviewers independently screened studies and extracted data. Study quality was assessed using the Newcastle-Ottawa Scale and Joanna Briggs Institute checklists. Random-effects meta-analyses were conducted to pool crude and adjusted ORs (aORs) and risk ratios (aRR) with 95% CIs. ORs and RRs were analysed separately. Between-study heterogeneity was quantified using the I 2 statistic.Results Of 15 467 records screened, 33 studies met the inclusion criteria. Women with any pre-existing mental health problems had higher odds and risks of adverse birth outcomes, including PTB (aOR 1.41, 95% CI 1.27 to 1.56) (aRR 1.36, 95% CI 1.21 to 1.51), LBW (aOR 1.28, 95% CI 1.22 to 1.33) (aRR 1.32, 95% CI 1.04 to 1.68), SGA (aOR 1.27, 95% CI 1.07 to 1.51) (aRR 1.34, 95% CI 1.19 to 1.51) and NNU admission (aOR 1.44, 95% CI 1.19 to 1.74). Adjusted estimates were based on multivariable models that commonly controlled for maternal age, parity and socio-demographic factors. No consistent associations were observed between pre-existing mental health problems and mode of birth.Conclusions Pre-existing mental health problems were associated with increased risks and odds of several adverse birth outcomes. These findings highlight the importance of early identification and targeted support for women with mental health problems before pregnancy to strengthen preconception and maternity care planning.PROSPERO registration number CRD42023485834.",
  "authors": [
    {
      "affiliations": [
        "National Perinatal Epidemiology Unit, University of Oxford Nuffield Department of Population Health, Oxford, UK"
      ],
      "name": "Jenny Gong"
    },
    {
      "affiliations": [
        "National Perinatal Epidemiology Unit, University of Oxford Nuffield Department of Population Health, Oxford, UK"
      ],
      "name": "Ian Henderson"
    },
    {
      "affiliations": [
        "Gove District Hospital, Nhulunbuy, Northern Territory, Australia"
      ],
      "name": "Rosie Lynch"
    },
    {
      "affiliations": [
        "National Perinatal Epidemiology Unit, University of Oxford Nuffield Department of Population Health, Oxford, UK"
      ],
      "name": "Zoe Daskalopoulou"
    },
    {
      "affiliations": [
        "Bodleian Health Care Libraries, Knowledge Centre ORC Research Building, University of Oxford, Oxford, UK"
      ],
      "name": "Nia Roberts"
    },
    {
      "affiliations": [
        "National Perinatal Epidemiology Unit, University of Oxford Nuffield Department of Population Health, Oxford, UK"
      ],
      "name": "Gracia Fellmeth"
    },
    {
      "affiliations": [
        "National Perinatal Epidemiology Unit, University of Oxford Nuffield Department of Population Health, Oxford, UK"
      ],
      "name": "Sian Harrison"
    },
    {
      "affiliations": [
        "National Perinatal Epidemiology Unit, University of Oxford Nuffield Department of Population Health, Oxford, UK"
      ],
      "name": "Maria A Quigley"
    },
    {
      "affiliations": [
        "National Perinatal Epidemiology Unit, University of Oxford Nuffield Department of Population Health, Oxford, UK"
      ],
      "name": "Fiona Alderdice"
    }
  ],
  "title": "Birth outcomes for women with pre-existing mental health problems: a systematic review and meta-analysis",
  "uid": "2badc1ac-e34a-5e6e-a168-fae63202dc26"
}