New-Onset Mental Illness Among Gestational Carriers

Area of Science:

• Reproductive Health
• Perinatal Mental Health
• Epidemiology

Background:

• Pregnancy presents heightened vulnerability for psychological well-being.
• The mental health of gestational carriers remains an understudied area.
• Existing research has not fully explored the mental health outcomes specific to gestational carriage.

Purpose of the Study:

• To investigate the association between gestational carriage and the incidence of new-onset mental illness.
• To compare mental illness rates in gestational carriers versus women conceiving through unassisted means or in vitro fertilization (IVF).

Main Methods:

• A population-based, retrospective cohort study in Ontario, Canada, included women without prior mental illness who gave birth between April 2012 and March 2021.
• Gestational carriers were compared with two control groups: women with unassisted conception and women with conception via IVF.
• New-onset mental illness was defined by specific healthcare utilization criteria, with outcomes analyzed using modified Poisson regression.

Main Results:

• Gestational carriers (0.1% of pregnancies) had a higher incidence of new-onset mental illness (6.9 per 100 person-years) compared to unassisted conception (5.2 per 100 person-years; adjusted IRR, 1.43) and IVF (5.0 per 100 person-years; adjusted IRR, 1.29).
• Gestational carriers were more likely to be older, have lower income, higher obesity, and chronic hypertension.
• The median follow-up duration was 4.5 years.

Conclusions:

• Gestational carriers demonstrate an increased likelihood of mental illness diagnoses during and post-pregnancy.
• Enhanced mental health screening, counseling, and support are crucial for gestational carrier populations.
• These findings underscore the importance of addressing the unique mental health needs of women undergoing gestational carriage.