We sought to determine the differences in pregnancy outcomes among white, black, Hispanic, Asian/Pacific Islander, Native American women with bipolar disorder.
A retrospective cohort of 3,344 women with bipolar disorder and singleton, non-anomalous gestations was used to examine maternal and neonatal outcomes, assessed according to race. Maternal outcomes included gestational diabetes (GDM), chorioamnionitis, postpartum hemorrhage (PPH), and preeclampsia/eclampsia (abbreviated “Any PET”). Neonatal outcomes included preterm birth (divided into <37, <34 and <32 weeks gestational age), respiratory distress syndrome (RDS), and jaundice. Multivariate regression analyses and chi-square tests were employed for statistical comparisons and a p-value of less than 0.05 was used to indicate statistical significance.
Compared to white women, and after controlling for confounders, Asian/Pacific Islander women were more likely to develop GDM, and chorioamnionitis, and trended towards higher rates of PPH. Additionally, black women trended towards higher rates of PET. Compared to neonates of white women, neonates of black women were more likely to be delivered preterm before 37, 34, and 32 weeks gestational age, and had higher rates of RDS. Additionally, Asian/Pacific Islander neonates trended towards higher rates of jaundice.
Pregnancies of non-white women with bipolar disorder are associated with higher rates of obstetric and neonatal complications than pregnancies of white women, with specific complications and rates varying across races. This data may suggest disparities exist in management of pregnant women with bipolar disorder across different races.