The impact of mental health disorders in pregnancy on obstetric and neonatal outcomes: A narrative review.

Perinatal psychiatry has gained increasing attention as a public health priority, given the high prevalence and burden of mental health conditions during pregnancy and the postpartum period. While research has predominantly focused on depressive disorders, growing evidence suggests that a broader range of psychiatric conditions may significantly influence obstetric and neonatal outcomes. Unlike previous works primarily centered on perinatal depression, this narrative review provides an integrated and transdiagnostic overview of perinatal psychiatric disorders - including mood, anxiety, psychotic, obsessive-compulsive, trauma-related disorders, and borderline personality disorder - and their association with adverse maternal, obstetric, and neonatal outcomes. Across diagnostic categories, psychiatric disorders during pregnancy are consistently associated with increased risks of hypertensive disorders, preterm birth, altered fetal growth, operative delivery, and neonatal complications. However, findings remain heterogeneous, largely derived from observational studies, and often limited by variability in diagnostic assessment and outcome definitions. Shared pathophysiological pathways- including hypothalamic-pituitary-adrenal axis dysregulation, inflammatory activation, hormonal fluctuations, and psychosocial stressors - may partially explain the convergence of different psychiatric disorders on similar perinatal outcomes. Taken together, these findings highlight the need to move beyond a depression-centered framework in perinatal psychiatry. Early identification, individualized risk-benefit assessment, and integrated multidisciplinary care may contribute to improved maternal and offspring outcomes. Future research should prioritize longitudinal designs and standardized outcome measures to disentangle disorder-specific and shared mechanisms.