Women with schizophrenia and their newborns are at risk of adverse pregnancy, delivery, neonatal and child outcomes. However, robust and informative epidemiological estimates are lacking to guide health policies to prioritise and organise perinatal services. For the first time, we carried out a systematic review and meta-analysis to synthesise the accumulating evidence on pregnancy, delivery, neonatal complications, and infant mortality among women with schizophrenia and their newborns (N = 43,611) vs. controls (N = 40,948,272) between 1999 and 2021 (26 population-based studies from 11 high-income countries) using random effects. Women with schizophrenia had higher odds (OR) of gestational diabetes (2.35, 95% CI: [1.57–3.52]), gestational hypertension, pre-eclampsia/eclampsia (OR 1.55, 95% CI: [1.02–2.36]; 1.85, 95% CI: [1.52–2.25]), antepartum and postpartum haemorrhage (OR 2.28, 95% CI: [1.58–3.29]; 1.14, 95% CI: [1.04–1.24]), placenta abruption, threatened preterm labour, and premature rupture of membrane (OR 2.20, 95% CI: [2.02–2.39]; 2.91, 95% CI: [1.57–5.40]; 1.29, 95% CI: [1.06–1.58]), c-section (OR 1.33, 95% CI: [1.22–1.45]), foetal distress (OR 1.80, 95% CI: [1.43–2.26]), preterm and very preterm delivery (OR 1.79, 95% CI: [1.62–1.98]; 2.31, 95% CI: [1.78–2.98]), small for gestational age and low birth weight (OR 1.63, 95% CI: [1.48–1.80]; 1.75, 95% CI: [1.46–2.11]), congenital malformations (OR 1.86, 95% CI: [1.71–2.03]), and stillbirths (OR 2.06, 95% CI: [1.83–2.31]). Their newborns had higher odds of neonatal death (OR 1.41, 95% CI: [1.03–1.94]), post-neonatal death (OR 2.87, 95% CI: [2.11–3.89]) and infant mortality (OR 2.33, 95% CI: [1.81–3.01]). This large‐scale meta‐analysis confirms that schizophrenia is associated with a substantially increased risk of very preterm delivery, stillbirth, and infant mortality, and metabolic risk in mothers. No population-based study has been carried out in low- and middle-income countries in which health problems of women with schizophrenia are probably more pronounced. More research is needed to better understand the complex needs of women with schizophrenia and their newborns, determine how care delivery could be optimised, and define best practices. Study registration: PROSPERO CRD42020197446.

患有精神分裂症的妇女及其新生儿有发生不良妊娠、分娩、新生儿和儿童结局的风险。然而，缺乏可靠和信息丰富的流行病学估计来指导卫生政策优先安排和组织围产期服务。我们首次进行了系统回顾和荟萃分析，以综合有关精神分裂症妇女及其新生儿 (N = 43,611) 与对照组 (N) 的妊娠、分娩、新生儿并发症和婴儿死亡率的 累积证据 = 40,948,272) 1999 年至 2021 年间（来自 11 个高收入国家的 26 项基于人口的研究）使用随机效应。患有精神分裂症的女性患妊娠糖尿病 (2.35, 95% CI: [1.57–3.52])、妊娠高血压、先兆子痫/子痫的几率 (OR) 较高 (OR 1.55, 95% CI: [1.02–2.36]; 1.85, 95% CI：[1.52–2.25]）、产前和产后出血（OR 2.28，95% CI：[1.58–3.29]；1.14，95% CI：[1.04–1.24]）、胎盘早剥、先兆早产和胎膜早破（OR 2.20，95% CI：[2.02–2.39]；2.91，95% CI：[1.57–5.40]；1.29，95% CI：[1.06–1.58]），剖腹产（OR 1.33， 95% CI：[1.22–1.45]），胎儿窘迫（OR 1.80，95% CI：[1.43–2.26]），早产和极早产（OR 1.79，95% CI：[1.62–1.98]；2.31，95 % CI：[1.78–2.98]），小于胎龄儿和低出生体重（OR 1.63，95% CI：[1.48–1.80]；1.75，95% CI：[1.46–2.11]）、先天性畸形（OR 1.86，95% CI：[1.71–2.03]）和死产（OR 2.06，95% CI：[1.83–2.31]）。他们的新生儿有更高的新生儿死亡几率 (OR 1.41, 95% CI: [1.03–1.94])、新生儿死亡 (OR 2.87, 95% CI: [2.11–3.89]) 和婴儿死亡率 (OR 2.33, 95%)可信区间：[1.81–3.01]）。这项大规模的荟萃分析证实，精神分裂症与极早产、死产和婴儿死亡率以及母亲代谢风险的显着增加有关。尚未在低收入和中等收入国家开展基于人口的研究，在这些国家中，患有精神分裂症的女性的健康问题可能更为明显。需要更多的研究来更好地了解患有精神分裂症的妇女及其新生儿的复杂需求，确定如何优化护理服务，并定义最佳实践。研究注册：PROSPERO CRD42020197446。