Table 3.
Risk of adverse birth outcomes, adjusted for specific covariates, among women with SMI diagnosis on maternal record
| Adverse birth outcomes | Relative Risk (95% CI) for
women with SMIa |
|||
|---|---|---|---|---|
| Base model | Base model with adjustment for substance use | Base model with adjustment for medical comorbidities | Fully adjusted model | |
| Adverse gestational outcomesb | 1.15 (1.13-1.17) | 1.14 (1.12-1.16) | 1.08 (1.06-1.10) | 1.08 (1.06-1.09) |
| Adverse obstetric outcomesc | 1.07 (1.06-1.08) | 1.05 (1.04-1.06) | 1.05 (1.04-1.06) | 1.03 (1.02-1.05) |
| Adverse fetal outcomesd | 1.24 (1.21-1.26) | 1.17 (1.15-1.19) | 1.18 (1.16-1.20) | 1.12 (1.10-1.14) |
| Adjusts for: | ||||
| Hospital & patient characteristicse | x | x | x | x |
| Substance usef | x | x | ||
| Medical comorbiditiesg | x | x | ||
Abbreviations: SMI, serious mental illness.
Diagnosis of major depressive disorder, bipolar disorder, and/or schizophrenia on maternal delivery record.
Preeclampsia, cervical complications, placental complications, amniotic complications, maternal complication during in utero procedure, hemorrhage in early pregnancy (<20 weeks), spotting, uterine size date discrepancy, late pregnancy.
Preterm birth, chorioamnionitis, failed mechanical or chemical induction, coagulation defects, forceps or vacuum extraction, complications with sedation, maternal distress, fetal-maternal hemorrhage, maternal hypotension, other indications for care or intervention, umbilical cord complications, long labor/ abnormality of forces, other obstetrical complications, infection/fever. Not including cesarean sections.
Poor fetal growth, single stillbirth, fetal malformations, excessive fetal growth, fetal hematologic conditions, fetal complication from in utero procedure, maternal nutritional disorders affecting fetus or newborn, maternal injury affecting fetus or newborn, chronic maternal circulatory and respiratory diseases affecting fetus or newborn, fetal distress, multiple birth stillborn, maternal infection affecting fetus.
Hospital and patient characteristics: race, age, payer, urban/rural location, U.S. region, weekend admission, emergency department admission, elective admission, income, admission year.
Substance use: alcohol use, illicit drug use, tobacco use.
Medical comorbidities: anemia, malposition/malpresentation, diabetes mellitus, obesity, thyroid dysfunction, viral/bacterial/parasitic infection, epilepsy.