Psychiatric vulnerability and the risk for unintended pregnancies, a systematic review and meta-analysis 33 Table 2.1 - Characteristics of the included studies. First author, year of publication Country Included participants (age range or mean) Study design Measurement of psychiatric disorder Unintended pregnancy assessment Results Easter et al., 2011 32 UK 171 women with anorexia nervosa (AN), 199 women with bulimia nervosa (BN), 82 women with both AN and BN in addition to 10636 women without psychiatric disorders. Mean age varied per group (minimum 28.2 years, SD 4.8 and maximum 29.2 years, SD 4.6) Prospective cohort study, crosssectional analysis of predictor and outcome of interest At 12 weeks of gestation, women were asked if they had any history of recent or past psychiatric problems including AN or BN. At 18 weeks’ gestation, women were asked if their current pregnancy was intentional UPs in AN group versus general group without psychiatric disorders: OR=2.0 (95% CI 1.42.5, p<0.001) Green et al., 200835 UK 39 pregnant women or up to 6 weeks postpartum, with a history of psychotic illness or who were at risk for postpartum psychosis, aged 19-40 years (mean 29.8) Prospective cohort study with crosssectional analysis of data on outcome of interest, audit forms were assessed. Screening for psychiatric disorders by a flowchart at the midwifery pregnancy intake58. After referral to a specialist clinic, the presence of a psychiatric condition was reported according to the International Classification of Diseases, ICD10 by a clinician Assessment of pregnancy planning was not reported. Intention was assessed during pregnancy up to 6 weeks postpartum 85% UPs in total study population (n=39) Gupta et al., 201939 Canada 1565 women, aged 18-49, with schizophrenia or schizoaffective disorder or psychotic disorder not otherwise specified were compared to 36.065 controls Retrospective cohort study Validated algorithm requiring one hospitalization or at least two outpatient visits with a diagnosis (based on DSM-IV criteria and ICD-10 codes) of schizophrenia, schizoaffective disorder or psychotic disorder not otherwise specified in the twoyear period prior to the index birth59 Induced abortions were assessed in patient files, captured by in the ICES datasets60 Relative risk of abortion in schizophrenia group versus no schizophrenia group: RR 1.07, 95% CI 0.81-1.42)
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