Pregnancy intention in relation to maternal and neonatal outcomes in women with vs without psychiatric diagnoses 83 Materials and methods Study design and eligibility criteria A retrospective cohort was compiled of women who gave birth in OLVG hospital, Amsterdam, the Netherlands. Women ≥18 years old with birth registrations in the electronic patient file during January 1, 2015 to March 1, 2020 were included. Women with twin pregnancies were excluded. We excluded all women with missing data on psychiatric history and/or pregnancy intention. After selection of all eligible women in the cohort, we included the most recent birth of each individual woman in the cohort, hence, all women were included only once (Figure 4.1). Data collection Data collection was conducted using CTcue, a software program that searches free text in pseudonymized electronic hospital charts. Multiple study investigators performed manual checks in hospital charts in case of missing data. Current/past psychiatric diagnosis The presence of a current/past psychiatric diagnosis, screened at the pregnancy intake according to the standardized protocol, was defined as one or more of the following: presence and/or history of a psychiatric diagnosis as reported by the pregnant woman herself or by one of her caretakers (general practitioner, midwife, gynecologist, psychiatrist, or psychologist). For the current study, the current/past psychiatric diagnosis had to be present at the beginning of the pregnancy. Aside from diagnosis (yes/no), diagnoses were subsequently classified according to the DSM-5 (depressive disorders, anxiety disorders etc.)22. If women used psychopharmacological drugs, they were included in the “current/past psychiatric diagnosis” group if they were also diagnosed with a psychiatric illness. However, if their diagnosis was not clear, women were included in the control group. Unintended pregnancy Unintended pregnancy was defined as a pregnancy that was not planned for, intended, and/or wanted at the time of conception as judged by the pregnant woman herself in retrospect. This information was written down in charts by a midwife or doctor. This variable was divided into four groups: “planned and wanted”, “planned and unwanted”, “unplanned and wanted”, or “unplanned and unwanted”. For the primary outcome we categorized all unplanned pregnancies as “unintended” pregnancies, both wanted and unwanted. All planned pregnancies were categorized
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