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Pregnancy in women with psychotic disorders: risk factors associated with mother-baby separation

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Abstract

Pregnancy in women suffering from psychotic disorders is becoming more common. However, this psychiatric disorder is linked to the highest risk of early mother and child separation. The aim of this study was to evaluate risk factors associated with these separations. In an observational, naturalist, and multicentric study, 320 women suffering from a psychotic disorder and jointly hospitalized with their child in one of the sixteen mother-baby units (MBUs) in France and Belgium between 2001 and 2010 were assessed for risk factors associated with mother-child separation. Eighty-seven (27.2%) mothers were separated from their infant at discharge from MBUs. Early separation was linked to the placement of the mother herself in an institution in childhood (OR 4.44; CI 95% 1.12–18.69), to the mother being single (OR 3.84; CI 95% 1.38–11.44), to early hospitalization of the baby in neonatology (OR 2.88; CI 95% 1.27–6.59), and to maternal psychiatric decompensation during pregnancy (OR 2.60; CI 95% 1.15–6.20), independently from maternal neglectful behaviors. Low family/social support showed a trend towards association with separation (OR 2.17; CI 95% 0.91–5.42). This study shows that separation is mostly linked to mothers’ environmental and interactive past and current history, to the child’s health, and to maternal mental health decompensation. The identification of these factors is essential to implement antenatal prevention and social programs for these women. Further studies should focus on the long-term development of children of schizophrenic mothers, whether or not they have been placed, in order to help clarifying the impact of the risk factors.

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Acknowledgments

The authors thank members of MBUs: Bordeaux, Montesson, Strasbourg, Le Vesinet, Créteil, Villejuif, Paris, Brussels, Limoges, Ottiginies, Marseille, Gent, Lille, Besançon, Albi, Brumath, who contributed to data collection and the women who participated in the study.

We also thank the Francophone Marcé Society.

Author information

Author notes

  1. Anne-Laure Sutter-Dallay and Florence Gressier contributed equally to this work.

Authors and Affiliations

  1. Department of Psychiatry, Assistance Publique-Hôpitaux de Paris, Univ Paris Sud, Bicêtre University Hospital, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France

    Agathe Cès & Florence Gressier

  2. Department of Biostatistics, Maison de Solenn, Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM U1178, 97 Bld de Port-Royal, 75679, Paris Cedex 14, France

    Bruno Falissard

  3. INSERM Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Biostatistics (U1153), Paris Descartes University, Paris, France

    Nine M. C. Glangeaud-Freudenthal

  4. Research Center Inserm 1219, Bordeaux Population Health Bordeaux University, University Department of Adult Psychiatry, Charles-Perrens Hospital, 33000, Bordeaux, France

    Anne-Laure Sutter-Dallay

  5. Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM U1178, Bicêtre University Hospital, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France

    Florence Gressier

Authors
  1. Agathe Cès
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  2. Bruno Falissard
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  4. Anne-Laure Sutter-Dallay
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  5. Florence Gressier
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Corresponding author

Correspondence to Florence Gressier.

Ethics declarations

All women provided informed consent for their inclusion in the database. The study was performed in accordance with the ethics standards of the French National Data Protection Authority (CNIL). The CNIL approved the study.

Conflict of interest

Regarding potential conflicts of interest, all of them were indirect:

Agathe Cès, Nine Glangeaud-Freudenthal, and Anne-Laure Sutter-Dallay report no financial relationships with commercial interests.

Bruno Falissard has been a consultant and expert or has given talks for E. Lilly, BMS, Servier, Sanofi, GlaxoSmithKline, HRA, Roche, Boeringer Ingelheim, Bayer, Almirall, Allergan, Stallergene, Genzyme, Pierre Fabre, Astra Zeneca, Novartis, Janssen, Astellas, Biotronik, Daiichi-Sankyo, Gilead, MSD, Lundbeck.

Florence Gressier has given talks for Lundbeck and Servier and received a grant from Servier for a postdoctoral degree (2011–2012).

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Cès, A., Falissard, B., Glangeaud-Freudenthal, N.M.C. et al. Pregnancy in women with psychotic disorders: risk factors associated with mother-baby separation. Arch Womens Ment Health 21, 699–706 (2018). https://doi.org/10.1007/s00737-018-0848-8

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  • DOI: https://doi.org/10.1007/s00737-018-0848-8

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