Perinatal outcomes and maternal health before and after single motherhood through assisted conception: A multiregistry study in Sweden.

Abstract

Introduction: Single motherhood by choice has been associated with increased perinatal risks and poorer psychological well-being for the families. However, limited evidence exists regarding the health status of these women before, during, and after pregnancy.

Material and methods: This prospective multiregistry study was conducted in Sweden and included unpartnered women conceiving with the help of assisted conception (n = 296) and all partnered women conceiving through IVF with the couple's own gametes (n = 7294), giving birth during 2007-2014. The primary outcomes assessed maternal somatic and mental health diagnoses 3 years before and after pregnancy, while secondary outcomes examined obstetric and neonatal complications. Data were retrieved from Swedish population-based registers, capturing ICD-10 diagnoses, filled prescriptions of psychiatric medications, and manually recorded perinatal data. Crude and adjusted logistic regression analyses were performed.

Results: Single mothers through assisted conception were older and had significantly higher rates of smoking and obesity compared to partnered women. They also had a higher prevalence of psychiatric diagnoses, including anxiety and depression, both before (14.2% vs. 4.3%, p < 0.001) and after childbirth (29.1 vs. 12.1%, p < 0.001). Psychiatric medication use was significantly higher among single mothers both before (34.1% vs. 13.8%, p < 0.001) and after pregnancy (34.5% vs. 15.0%, p < 0.001). Obstetric and neonatal outcomes, including preterm birth and low birth weight, showed no significant differences between the groups, except for a higher incidence of multiple births among single mothers. The index population had a twofold increased risk of psychiatric conditions or medications, despite adjustment, in the period immediately before [aOR 2.51 (1.92-3.27)] or after childbirth [aOR 2.00 (1.51-2.66)].

Conclusions: The study reveals that single mothers through assisted conception face increased psychiatric risks before and after childbirth compared to partnered women undergoing autologous IVF. The findings highlight the need for careful eligibility assessment by healthcare professionals and underscore the importance of ensuring a robust support system to help these mothers manage the challenges of solo parenthood.