Gestational Carriers at Higher Risk for Mental Illness, Emphasizing Need for Support: JAMA

A new study published in the Journal of American Medical Association showed that during and after pregnancy, gestational carriers are more likely to receive a diagnosis of a new mental disease. There is a greater risk to one's psychological health during pregnancy. Thus, this study was set to examine the relationship between new-onset mental illness and gestational carriage.

In this research, all women in the Canadian province of Ontario who gave birth at more than 20 weeks’ gestation between April 1, 2012, and March 31, 2021, and who had no known mental illness prior to pregnancy were included. Analysis of the data was place between September 10, 2024, and May 23, 2025. Non-gestational carriers who conceived naturally (comparison 1) or through in vitro fertilization (IVF) (comparison 2) were compared to gestational carriers.

A diagnosis of new-onset mental illness based on 2 or more outpatient visits, one or more ED visits, or a hospital admission that occurred between the projected date of conception and the maximum follow-up date of March 31, 2024, was the primary outcome. Incidence rate ratios (IRRs) derived using modified Poisson regression that were corrected for parity, obesity, smoking, chronic hypertension, mother age, income quintile, and urban residency.

A total of 748,732 (97.6%) of the 767,406 pregnancies in women (mean [SD] age, 30.5 [5.1] years) that were eligible were conceived naturally, 17,916 (2.3%) by IVF, and 758 (0.1%) through gestational carriage.

When compared with unassisted conception and IVF carriers, gestational carriers were far more likely to be parous (91.2% vs. 57.9% and 34.1%, respectively), live in a lower-income area (23.4% vs. 21.9% and 12.1%, respectively), and have higher rates of chronic hypertension (3.2% vs. 1.6% and 2.9%, respectively) and obesity (36.1% vs. 17.0% and 17.1%, respectively). A follow-up of 4.5 (2.3-7.2) years was the median (IQR).

Almost, 236 gestational carriers (6.9 per 100 person-years) and 195,022 women with unaided conception (5.2 per 100 person-years) experienced new-onset mental illness, according to comparison 1 (adjusted IRR, 1.43; 95% CI, 1.26-1.63).

In contrast, 4,704 IVF recipients (5.0 per 100 person-years) and 236 gestational carriers (6.9 per 100 person-years) had new-onset mental illness (adjusted IRR, 1.29; 95% CI, 1.13-1.47). Overall, based on the results of this cohort research, there was a higher risk of mental disorder diagnoses during and after pregnancy among gestational carriers.

Source:

Velez, M. P., Dayan, N., Vigod, S. N., Buckett, W., Flatt, S., Shellenberger, J., & Ray, J. G. (2025). New-onset mental illness among gestational carriers. JAMA Network Open, 8(7), e2523428. https://doi.org/10.1001/jamanetworkopen.2025.23428