Importance of Preconception Care for Optimizing Fetal Growth in Pregnancies Complicated by Psychiatric Disorders.

AIM: To investigate the determinants of fetal growth abnormalities such as large for gestational age (LGA) and small for gestational age (SGA) in singleton pregnancies complicated by maternal psychiatric disorders, particularly focusing on the impact of psychotropic medication exposure and maternal background factors on infants. METHODS: A retrospective single-center cohort study was conducted involving 400 singleton pregnancies complicated by maternal psychiatric disorders, with deliveries occurring between 2019 and 2023. Data regarding maternal characteristics, psychiatric diagnoses, psychotropic medication use including polypharmacy and metabolically high-risk psychotropic medications, and obstetric outcomes were extracted from medical records. Infants were classified as LGA or SGA according to gestational age-specific birth weight standards. Multivariable logistic regression analyses were performed to identify independent factors associated with LGA and SGA. RESULTS: Of the 400 pregnancies, 40 infants were classified as LGA and 40 as SGA. Psychotropic medication use, including polypharmacy and metabolically high-risk psychotropic medications, was not independently associated with either LGA or SGA. For LGA, only high prepregnancy BMI was identified as an independent risk factor. For SGA, hypertensive disorders of pregnancy, maternal alcohol consumption, and lower prepregnancy BMI were independently associated with increased risk. CONCLUSIONS: In pregnancies complicated by psychiatric disorders, fetal growth abnormalities were primarily associated with maternal background factors. No statistically significant association was identified between psychotropic medication use and LGA or SGA fetuses in our study cohort. These findings highlight the potential importance of preconception care focused on optimizing metabolic health and lifestyle factors to improve fetal growth outcomes.