What does this research mean for the field?

Women with pre-existing mental health problems prior to pregnancy have a significantly increased risk of adverse birth outcomes, including preterm birth, low birth weight, small for gestational age, and neonatal unit admission. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This research aims to evaluate the link between pre-existing mental health issues and adverse birth outcomes.

May 31, 2026Open Access

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

Key Points

This research aims to evaluate the link between pre-existing mental health issues and adverse birth outcomes.
Systematic searches in MEDLINE, CINAHL, Embase, and PsycINFO for relevant studies.
Data were extracted by two independent reviewers and study quality assessed using recognized scales.
Random-effects meta-analyses computed crude and adjusted odds ratios and risk ratios with 95% confidence intervals.
Women with pre-existing mental health problems had higher odds of preterm birth (aOR 1.41, 95% CI 1.27 to 1.56).
Increased risks of low birth weight (aOR 1.28, 95% CI 1.22 to 1.33) and small for gestational age (aOR 1.27, 95% CI 1.07 to 1.51) observed.
Admission to the neonatal unit was also significantly higher (aOR 1.44, 95% CI 1.19 to 1.74).

Abstract

Objectives To 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). Methods Systematic 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 2 statistic. Results Of 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. Conclusions Pre-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.

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