Evidence map›Paper›PMID 42215270›Full record

SynthesisBMJ open2026

Birth outcomes for women with pre-existing mental health problems: a systematic review and meta-analysis.

Jenny Gong, Ian Henderson, Rosie Lynch, Zoe Daskalopoulou, Nia Roberts, Gracia Fellmeth, Sian Harrison, Maria A Quigley, Fiona Alderdice

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jenny GongNational Perinatal Epidemiology Unit, University of Oxford Nuffield Department of Population Health, Oxford, UK jenny.gong@exeter.ox.ac.uk.ORCID http://orcid.org/0000-0002-4018-8963
Ian HendersonNational Perinatal Epidemiology Unit, University of Oxford Nuffield Department of Population Health, Oxford, UK.
Rosie LynchGove District Hospital, Nhulunbuy, Northern Territory, Australia.
Zoe DaskalopoulouNational Perinatal Epidemiology Unit, University of Oxford Nuffield Department of Population Health, Oxford, UK.
Nia RobertsBodleian Health Care Libraries, Knowledge Centre ORC Research Building, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0002-1142-6440
Gracia FellmethNational Perinatal Epidemiology Unit, University of Oxford Nuffield Department of Population Health, Oxford, UK.ORCID http://orcid.org/0000-0002-0537-2490
Sian HarrisonNational Perinatal Epidemiology Unit, University of Oxford Nuffield Department of Population Health, Oxford, UK.ORCID http://orcid.org/0000-0002-4186-4169
Maria A QuigleyNational Perinatal Epidemiology Unit, University of Oxford Nuffield Department of Population Health, Oxford, UK.
Fiona AlderdiceNational Perinatal Epidemiology Unit, University of Oxford Nuffield Department of Population Health, Oxford, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo synthesise evidence on the association between any diagnosed or self-reported mental health problems prior to pregnancy (pre-existing mental health problems) and birth outcomes including preterm birth (PTB), low birth weight (LBW), small for gestational age (SGA), neonatal unit (NNU) admission and mode of birth (instrumental birth, planned or unplanned caesarean section).

methodsSystematic searches were conducted in MEDLINE, CINAHL, Embase and PsycINFO in December 2024 for studies examining the association between any pre-existing mental health problems and PTB, LBW, SGA, NNU admission and mode of birth. Only articles published in English were included with no restriction on year of publication. Two reviewers independently screened studies and extracted data. Study quality was assessed using the Newcastle-Ottawa Scale and Joanna Briggs Institute checklists. Random-effects meta-analyses were conducted to pool crude and adjusted ORs (aORs) and risk ratios (aRR) with 95% CIs. ORs and RRs were analysed separately. Between-study heterogeneity was quantified using the I

resultsOf 15 467 records screened, 33 studies met the inclusion criteria. Women with any pre-existing mental health problems had higher odds and risks of adverse birth outcomes, including PTB (aOR 1.41, 95% CI 1.27 to 1.56) (aRR 1.36, 95% CI 1.21 to 1.51), LBW (aOR 1.28, 95% CI 1.22 to 1.33) (aRR 1.32, 95% CI 1.04 to 1.68), SGA (aOR 1.27, 95% CI 1.07 to 1.51) (aRR 1.34, 95% CI 1.19 to 1.51) and NNU admission (aOR 1.44, 95% CI 1.19 to 1.74). Adjusted estimates were based on multivariable models that commonly controlled for maternal age, parity and socio-demographic factors. No consistent associations were observed between pre-existing mental health problems and mode of birth.

conclusionsPre-existing mental health problems were associated with increased risks and odds of several adverse birth outcomes. These findings highlight the importance of early identification and targeted support for women with mental health problems before pregnancy to strengthen preconception and maternity care planning. PROSPERO REGISTRATION NUMBER: CRD42023485834.

Indexed as

Mental DisordersPregnancy ComplicationsPregnancy OutcomeFemaleHumansInfant, Low Birth WeightInfant, NewbornInfant, Small for Gestational AgePregnancyPremature BirthMENTAL HEALTHMeta-AnalysisPregnancySystematic Review

Identifiers

PMID42215270
PMCPMC13223673

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.