Preconception parental personality disorder and psychosocial outcomes during the perinatal period: a prospective population-based study

PURPOSE: Birthing individuals with personality disorder in young adulthood before pregnancy may be at increased risk of potentially modifiable adverse outcomes in the perinatal period that impact parental and child health. We aimed to investigate the perinatal psychosocial outcomes of preconception (prior to pregnancy) personality disorder. METHODS: Prospective analysis of 398 birthing individuals with 609 infants from Victorian Intergenerational Health Cohort Study (VIHCS). Preconception personality disorder was measured using the Standardised Assessment of Personality (SAP) at age 24. A range of parental outcomes were assessed during pregnancy and at one year postpartum (age 28 to 37). Log-binomial generalised estimating equations were used to estimate univariable associations between preconception personality disorder and each perinatal outcome. RESULTS: Individuals with preconception personality disorder (compared to those without) were approximately two times more likely to have antenatal anxiety symptoms (risk ratio (RR) 2.08, 95% confidence interval (CI) 1.19-3.65) and reduced social support (antenatal RR 2.01, 95% CI 0.98-4.13; postnatal RR 1.38, 95% CI 0.91-2.10). Weaker associations were also observed for experiencing stressful life events (RR 1.37, 95% CI 0.98-1.90) and, albeit with less certainty, for poorer partner relationship quality (RR 1.44, 95% CI 0.78-2.64) and depressive symptoms (antenatal RR 1.56, 95% CI 0.84-2.91; postnatal RR 1.44, 95% CI 0.73-2.83). Close to null associations were observed for parents' self-efficacy or perceived parent-infant bond. CONCLUSION: The findings highlight a group who may be vulnerable to multiple adverse perinatal outcomes; those with personality disorder and their families may benefit from additional support both with pregnancy planning and into parenthood.