Obstetric Risk Factors and Subsequent Mental Health Problems in a Child Psychiatry Clinic Population in Nigeria

Abstract

Background: Studies suggest that obstetric complications are associated with several child psychiatric conditions. In planning for child psychiatric services it is important to monitor patterns of morbidity and associated risk factors. Identifying obstetric risk factors in a newly opened child psychiatric clinic population with provide crucial information for future planning and collaboration. Objective: To determine the prevalence and pattern of obstetric risk factors and associations with morbidity found in a child psychiatric clinic population. Method: The study population consisted of all attendees at a newly opened child and adolescent psychiatric clinic at the University College Hospital, Ibadan. All attendees had a standardised comprehensive psychiatric assessment and an obstetric history was obtained from mothers. Results: In the period under study, 144 children and adolescents were referred to this clinic. Obstetrical complications were found in 32 (29%) of the 112 children from whom this history was obtained. The commonest complications were birth asphyxia (11%), and emergency caesarean sections (6%). Delivery complications were associated with unskilled fathers\' (x2 =8.4; p=0.015) and mothers above 40 years of age, (x2 =9.5; p=0.011). Children with mental retardation were more likely to have suffered birth injuries (x2 =14.05; p=0.000). The highest number of obstetric complications occurred in children with disruptive behaviour disorder (42.9%), and autistic disorder (33.3%). No statistically significant relationship was found between specific groups and obstetric complications. Conclusion:This descriptive study illustrates that obstetric complications are a contributing factor to mental health problems in children. Many of the complications could have been prevented with better health care. Further studies may also want to compare obstetric complications in this child psychiatric clinic population with a sample of children in the general population. Key Words: obstetric risk factors, child psychiatric disorders. [Trop J Obstet Gynaecol, 2004;21:15-20]