B Rotberg1, E Horváth-Puhó2, S Vigod3,4, J G Ray3,5, H T Sørensen2,6, E Cohen2,3,7. 1. Department of Psychiatry, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada. 2. Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. 3. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. 4. Department of Psychiatry, Women's College Hospital, University of Toronto, Toronto, ON, Canada. 5. St. Michael's Hospital Department of Medicine, University of Toronto, Toronto, ON, Canada. 6. Division of Epidemiology, Department of Health Research and Policy, Stanford University, Stanford, CA, USA. 7. Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
Abstract
BACKGROUND: The birth of a child with a major congenital anomaly may create chronic caregiving stress for mothers, yet little is known about their psychiatric outcomes. AIMS: To evaluate the association of the birth of a child with a major congenital anomaly with subsequent maternal psychiatric risk. METHODS: This Danish nationwide cohort study included mothers who gave birth to an infant with a major congenital anomaly (n = 19 220) between 1997 and 2015. Comparators were randomly selected mothers, matched on maternal age, year of delivery and parity (n = 195 399). The primary outcome was any new-onset psychiatric diagnosis. Secondary outcomes included specific psychiatric diagnoses, psychiatric in-patient admissions and redeemed psychoactive medicines. Cox models were used to estimate hazard ratios (HRs), adjusted for socioeconomic and medical variables. RESULTS: Mothers of affected infants had an elevated risk for a new-onset psychiatric disorder vs. the comparison group (adjusted HR, 1.16, 95% CI 1.11-1.22). The adjusted HR was particularly elevated during the first postpartum year (1.65, 95% CI 1.42-1.90), but remained high for years, especially among mothers of children with multiorgan anomalies (1.37, 95% CI 1.18-1.57). The risk was also elevated for most specific psychiatric diagnoses, admissions and medicines. CONCLUSIONS: Mothers who give birth to a child with a major congenital anomaly are at increased risk of new-onset psychiatric disorders, especially shortly after birth and for mothers of children with more severe anomalies. Our study highlights the need to screen for mental illness in this high-risk population, as well as to integrate adult mental health services and paediatric care.
BACKGROUND: The birth of a child with a major congenital anomaly may create chronic caregiving stress for mothers, yet little is known about their psychiatric outcomes. AIMS: To evaluate the association of the birth of a child with a major congenital anomaly with subsequent maternal psychiatric risk. METHODS: This Danish nationwide cohort study included mothers who gave birth to an infant with a major congenital anomaly (n = 19 220) between 1997 and 2015. Comparators were randomly selected mothers, matched on maternal age, year of delivery and parity (n = 195 399). The primary outcome was any new-onset psychiatric diagnosis. Secondary outcomes included specific psychiatric diagnoses, psychiatric in-patient admissions and redeemed psychoactive medicines. Cox models were used to estimate hazard ratios (HRs), adjusted for socioeconomic and medical variables. RESULTS: Mothers of affected infants had an elevated risk for a new-onset psychiatric disorder vs. the comparison group (adjusted HR, 1.16, 95% CI 1.11-1.22). The adjusted HR was particularly elevated during the first postpartum year (1.65, 95% CI 1.42-1.90), but remained high for years, especially among mothers of children with multiorgan anomalies (1.37, 95% CI 1.18-1.57). The risk was also elevated for most specific psychiatric diagnoses, admissions and medicines. CONCLUSIONS: Mothers who give birth to a child with a major congenital anomaly are at increased risk of new-onset psychiatric disorders, especially shortly after birth and for mothers of children with more severe anomalies. Our study highlights the need to screen for mental illness in this high-risk population, as well as to integrate adult mental health services and paediatric care.
Authors: Nirav R Shah; Kyung Mi Kim; Venus Wong; Eyal Cohen; Sarah Rosenbaum; Eli M Cahan; Arnold Milstein; Henrik Toft Sørensen; Erzsébet Horváth-Puhó Journal: PLoS One Date: 2021-12-08 Impact factor: 3.240
Authors: Eyal Cohen; Péter Szentkúti; Erzsébet Horváth-Puhó; Hilary K Brown; Sonia M Grandi; Henrik Toft Sørensen; Joel G Ray Journal: Clin Epidemiol Date: 2022-03-31 Impact factor: 4.790