Peripartum complications associated with obsessive compulsive disorder exacerbation during pregnancy

Calliope Holingue, Jack Samuels, Valeria Guglielmi, Wendy Ingram, Gerald Nestadt, Paul S. Nestadt

Research output: Contribution to journalArticlepeer-review


Prior research has shown that onset or exacerbation of OCD is associated with menstruation, pregnancy, and the post-partum period. However, the underlying cause is unclear. The goal of this study was to assess whether pregnancy and birth complications were associated with OCD symptoms exacerbation, among women with established OCD. Two-hundred and five (n = 205) women with OCD retrospectively reported information on their physical and mental health during their first pregnancy. Over a third of the sample (34%) reported an exacerbation in their OCD symptoms. History of pregnancy and birth complications in the first pregnancy were similar between women who did and did not experience symptom exacerbation, with the exception of gestational diabetes, which was significantly more common among women who experienced exacerbation (7% vs 1%, p = 0.03). In a multivariable logistic regression model, gestational diabetes remained significantly associated with exacerbation of OCD symptoms (OR = 8.44 [95% CI 1.37–77.27]; p = 0.03), even after adjusting for maternal age, OCD severity and treatment, premenstrual OCD symptom increase, stress during pregnancy, and major depression or anxiety disorder diagnosis during pregnancy. We discuss potential explanations for this link. These findings should be treated as hypothesis-generating and need to be replicated in a larger, prospective study.

Original languageEnglish (US)
Article number100641
JournalJournal of Obsessive-Compulsive and Related Disorders
StatePublished - Apr 2021


  • Exacerbation
  • Hormonal
  • Obsessive-compulsive disorder
  • Pregnancy
  • Reproductive

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


Dive into the research topics of 'Peripartum complications associated with obsessive compulsive disorder exacerbation during pregnancy'. Together they form a unique fingerprint.

Cite this