General and age-specific fertility rates in non-affective psychosis: population-based analysis of Scottish women

MacBeth, A., Mcskimming, P., Bhattacharya, S., Park, J., Gumley, A. , St Clair, D. and Berry, S. J.E. (2023) General and age-specific fertility rates in non-affective psychosis: population-based analysis of Scottish women. Social Psychiatry and Psychiatric Epidemiology, 58(1), pp. 105-112. (doi: 10.1007/s00127-022-02313-y) (PMID:35648175) (PMCID:PMC9845143)

Abstract

Purpose: Women diagnosed with non-affective psychosis have a lower general fertility rate (GFR) and age-specific fertility rate (ASFR) than women in the general population. Contemporary data on GFR in this group remains limited, despite substantive changes in prescribing and management. We calculated contemporary estimates of the GFR and ASFR for women diagnosed with non-affective psychosis compared with the general population of women without this diagnosis. Methods: A population-based design combined routinely collected historical maternity and psychiatric data from two representative areas of Scotland. Women were included from the NHS Grampian or Greater Glasgow and Clyde areas and were aged 15-44 between 2005 and 2013 inclusive. The 'exposed' group had a diagnosis of non-affective psychosis (ICD-10 F20 – F29) and were compared to the general population of 'unexposed' women in the same geographical areas. Results: Annual GFR between 2005 and 2013 for women with non-affective psychopsis varied from 9.6 – 21.3 live births/1000 women per year in the exposed cohort and 52.7 to 57.8 live births/1000 women per year in the unexposed cohort, a Rate Ratio (RR) of 0.28 (p < 0.001; 95% CI (0.24, 0.32). ASFR for all 5-year age groups was lower in the exposed cohort than amongst unexposed women. Conclusion: We highlight continued low fertility rates in women with a diagnosis of non-affective psychosis, despite widespread availability of prolactin-sparing atypical antipsychotics. Accurate estimation of fertility rates remains crucial in developing needs-matched perinatal care for these women. Methodological improvements using routine datasets to investigate perinatal mental health are also urgently needed.

• Item Type: Articles
• Additional Information: The study was funded by Chief Scientist Office, Scottish Government Health and Social Care Directorate (Grant CZH/4/951), NHS Research Scotland (NHS Research Scotland Career Research Fellowship).
• Keywords: Schizophrenia, fertility, women, antipsychotics, psychotic disorders.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: MacBeth, Mr Angus and Gumley, Professor Andrew and Mcskimming, Mrs Paula
• Authors: MacBeth, A., Mcskimming, P., Bhattacharya, S., Park, J., Gumley, A., St Clair, D., and Berry, S. J.E.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: Social Psychiatry and Psychiatric Epidemiology
• Publisher: Springer
• ISSN: 0933-7954
• ISSN (Online): 1433-9285
• Published Online: 01 June 2022
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in Social Psychiatry and Psychiatric Epidemiology 58(1): 105-112
• Publisher Policy: Reproduced under a Creative Commons License

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
190856		Maternity-related outcomes in women with a diagnosis of psychotic disorder: a case-control data-linkage study in two Scottish cohorts	Sarah Barry	Office of the Chief Scientific Adviser (CSO)	RA3442 (CZH/4/951)	HW - Robertson Centre