Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jan;58(1):105-112.
doi: 10.1007/s00127-022-02313-y. Epub 2022 Jun 1.

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

Angus MacBeth  1   2 , Paula McSkimming  3 , Sohinee Bhattacharya  4 , John Park  5 , Andrew Gumley  6 , David St Clair  4 , Sarah J E Barry  7
Affiliations

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

Angus MacBeth et al. Soc Psychiatry Psychiatr Epidemiol. 2023 Jan.

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 remain 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 was 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 psychosis varied from 9.6 to 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.

Keywords: Antipsychotics; Fertility; Psychotic disorders; Schizophrenia; Women.

PubMed Disclaimer

Conflict of interest statement

AM is a member of the steering group for the NHS Scotland Perinatal Mental Health Managed Clinical Network. They receive no payment or this. There are no other conflicts of interest to declare from the authors.

Figures

Fig. 1
Fig. 1
General fertility rate (GFR) per 1000 women with smoothed 95% confidence bands for women aged 15–44 with a diagnosis of non-affective psychosis (exposed) vs women in the general population (unexposed) between 2005 and 2013
Fig. 2
Fig. 2
Age-specific fertility rates (ASFR) per 1000 women with smoothed 95% confidence bands by age category for women aged 15–44 with a diagnosis of non-affective psychosis vs women in the general population (unexposed) between 2005 and 2013
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Howard LM, Kumar C, Leese M, Thornicroft G. The general fertility rate in women with psychotic disorders. Am J Psychiatry. 2002;159(6):991–997. doi: 10.1176/appi.ajp.159.6.991. - DOI - PubMed
    1. Bundy H, Stahl D, MacCabe JH. A systematic review and meta-analysis of the fertility of patients with schizophrenia and their unaffected relatives. Acta Psychiatr Scand. 2011;123(2):98–106. doi: 10.1111/j.1600-0447.2010.01623.x. - DOI - PubMed
    1. McGrath JJ, Hearle J, Jenner L, Plant K, Drummond A, Barkla J. The fertility and fecundity of patients with psychoses. Acta Psychiatr Scand. 1999;99(6):441–446. doi: 10.1111/j.1600-0447.1999.tb00990.x. - DOI - PubMed
    1. Jablensky AV, Morgan V, Zubrick SR, Bower C, Yellachich L-A. Pregnancy, delivery, and neonatal complications in a population cohort of women with schizophrenia and major affective disorders. Am J Psychiatry. 2005;162(1):79–91. doi: 10.1176/appi.ajp.162.1.79. - DOI - PubMed
    1. Webb RT, Howard L, Abel KM. Antipsychotic drugs for non-affective psychosis during pregnancy and postpartum. Cochrane Library. 2004 doi: 10.1002/14651858.CD004411.pub2. - DOI - PubMed

Substances