New-Onset Mental Illness Among Gestational Carriers

Area of Science:

• Reproductive Health
• Mental Health Outcomes
• Perinatal Psychiatry

Background:

• Increasing trend in births via gestational carriers.
• Limited research on mental health outcomes for gestational carriers.
• Pregnancy heightens vulnerability to mental illness; higher severe maternal morbidity noted in gestational carriers.

Purpose of the Study:

• To assess the risk of new-onset mental illness in gestational carriers.
• Comparison group: women conceiving unassisted and via in vitro fertilization (IVF).
• Investigate mental health disparities in assisted reproductive technologies.

Main Methods:

• Population-based study (2012-2021) in Ontario, Canada.
• Included births >20 weeks gestation, women aged 18-50.
• Primary outcome: new-onset mental illness (mood, anxiety, psychosis, substance use, self-harm) defined by healthcare utilization; compared gestational carriers, unassisted conception, and IVF.

Main Results:

• Gestational carriers showed higher rates of new-onset mental illness (6.9 per 100 person-years) compared to unassisted conception (5.2) and IVF (5.0).
• Incidence rate ratios (IRRs) indicated significantly higher risk for gestational carriers (IRR 1.43 vs. unassisted; adjusted IRR 1.29 vs. IVF).
• Gestational carriers were more likely to be parous, live in lower-income areas, and have higher rates of obesity and chronic hypertension.

Conclusions:

• Gestational carriers have an elevated risk of developing new-onset mental illness.
• Findings highlight the critical need for improved mental health screening and support systems for individuals serving as gestational carriers.
• Further research into specific risk factors and interventions is warranted.