Chronic Medical Conditions and Perinatal Mental Illness: A Systematic Review and Meta-Analysis

Abstract

The objective of this systematic review and meta-analysis was to examine the association between maternal chronic medical conditions (CMC) and perinatal mental illness. Medline, EMBASE, CINAHL, and PsycINFO were searched to September, 2017. Data were extracted and quality was assessed using standardized instruments. We generated unadjusted and adjusted pooled odds ratios (aPOR) and 95% confidence intervals (CI) using DerSimonian and Laird random effects models. The review included 16 papers representing 12 studies and 1,626,260 women. CMC overall was associated with perinatal mental illness overall (aPOR = 1.43, 95% CI: 1.25, 1.63). CMC overall was associated with antenatal (aPOR = 1.41, 95% CI: 1.10, 1.81) and postnatal mental illness separately (aPOR = 1.44, 95% CI: 1.13, 1.85) and with perinatal depression (aPOR = 1.45, 95% CI: 1.25, 1.67) and anxiety separately (aPOR = 1.63, 95% CI: 1.35, 1.95). No studies examined bipolar or psychotic disorders. Diabetes (aPOR = 1.34, 95% CI: 1.07, 1.69), hypertension/heart disease (aPOR = 1.60, 95% CI: 1.05, 2.45), migraine (aPOR = 1.75, 95% CI: 1.20, 2.54), and other neurological disorders (aPOR = 1.45, 95% CI: 1.19, 1.77), but not asthma, were each associated with perinatal mental illness. Findings suggest that mental health resources should be integrated in medical settings where pregnant and postnatal women with CMC are treated.