Dorothy Thornton1, Sylvia Guendelman, Nap Hosang. 1. Division of Community Health and Human Development, Berkeley School of Public Health, University of California, University Hall, Berkeley 415-596-6569, CA 94720, USA. dthornto@berkeley.edu
Abstract
OBJECTIVE: To examine disparities in serious obstetric complications and quality of obstetric care during labor and delivery for women with and without mental illness. DATA SOURCE: Linked California hospital discharge (2000-2001), birth, fetal death, and county mental health system (CMHS) records. STUDY DESIGN: This population-based, cross-sectional study of 915,568 deliveries in California, calculated adjusted odds ratios (AORs) for obstetric complication rates for women with a mental illness diagnosis (treated and not treated in the CMHS) compared with women with no mental illness diagnosis, controlling for sociodemographic, delivery hospital type, and clinical factors. RESULTS: Compared with deliveries in the general non-mentally ill population, deliveries to women with mental illness stand a higher adjusted risk of obstetric complication: AOR=1.32 (95 percent confidence interval [CI]=1.25, 1.39) for women treated in the CMHS and AOR=1.72 (95 percent CI=1.66, 1.79) for women not treated in the CMHS. Mentally ill women treated in the CMHS are at lower risk than non-CMHS mentally ill women of experiencing conditions associated with suboptimal intrapartum care (postpartum hemorrhage, major puerperal infections) and inadequate prenatal care (acute pyelonephritis). CONCLUSION: Since mental disorders during pregnancy adversely affect mothers and their infants, care of the mentally ill pregnant woman by mental health and primary care providers warrants special attention.
OBJECTIVE: To examine disparities in serious obstetric complications and quality of obstetric care during labor and delivery for women with and without mental illness. DATA SOURCE: Linked California hospital discharge (2000-2001), birth, fetal death, and county mental health system (CMHS) records. STUDY DESIGN: This population-based, cross-sectional study of 915,568 deliveries in California, calculated adjusted odds ratios (AORs) for obstetric complication rates for women with a mental illness diagnosis (treated and not treated in the CMHS) compared with women with no mental illness diagnosis, controlling for sociodemographic, delivery hospital type, and clinical factors. RESULTS: Compared with deliveries in the general non-mentally ill population, deliveries to women with mental illness stand a higher adjusted risk of obstetric complication: AOR=1.32 (95 percent confidence interval [CI]=1.25, 1.39) for women treated in the CMHS and AOR=1.72 (95 percent CI=1.66, 1.79) for women not treated in the CMHS. Mentally illwomen treated in the CMHS are at lower risk than non-CMHS mentally illwomen of experiencing conditions associated with suboptimal intrapartum care (postpartum hemorrhage, major puerperal infections) and inadequate prenatal care (acute pyelonephritis). CONCLUSION: Since mental disorders during pregnancy adversely affect mothers and their infants, care of the mentally ill pregnant woman by mental health and primary care providers warrants special attention.
Authors: Lisa M Korst; Carolina Reyes; Moshe Fridman; Michael C Lu; Calvin J Hobel; Kimberly D Gregory Journal: Obstet Gynecol Date: 2006-03 Impact factor: 7.661
Authors: R H Kelly; B H Danielson; D F Zatzick; M N Haan; T F Anders; W M Gilbert; V K Burt Journal: Am J Psychiatry Date: 1999-06 Impact factor: 18.112
Authors: Assen V Jablensky; Vera Morgan; Stephen R Zubrick; Carol Bower; Li-Anne Yellachich Journal: Am J Psychiatry Date: 2005-01 Impact factor: 18.112