Marie-Paule Austin1,2,3, Taryn L Ambrosi4, Nicole Reilly5,6,7, Maxine Croft4, Jolie Hutchinson8, Natasha Donnolley9, Cathrine Mihalopoulos10, Mary Lou Chatterton10, Georgina M Chambers9, Elizabeth Sullivan11,12, Catherine Knox13, Fenglian Xu14, Nicole Highet15, Vera A Morgan4,16. 1. Perinatal and Women's Mental Health Unit, St John of God Burwood Hospital, Burwood, NSW, Australia. m.austin@unsw.edu.au. 2. Perinatal and Women's Mental Health, Royal Hospital for Women, Randwick, NSW, Australia. m.austin@unsw.edu.au. 3. School of Psychiatry, University of New South Wales, Sydney, Australia. m.austin@unsw.edu.au. 4. Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, University of Western Australia, Nedlands, Australia. 5. Perinatal and Women's Mental Health Unit, St John of God Burwood Hospital, Burwood, NSW, Australia. 6. School of Psychiatry, University of New South Wales, Sydney, Australia. 7. Centre for Health Service Development, Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW, Australia. 8. Biostatistics and Database Program, The Kirby Institute University of New South Wales, Sydney, Australia. 9. National Perinatal Epidemiology and Statistics Unit, Centre for Big Data Research in Health and School of Women's and Children's Health, University of New South Wales, Sydney, Australia. 10. Deakin Health Economics, Deakin University, Geelong, VIC, Australia. 11. Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia. 12. Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia. 13. Gidget Foundation, North Sydney, NSW, Australia. 14. Translational Cancer Research Network, Lowry Cancer Research Centre, University of New South Wales, Sydney, NSW, Australia. 15. Centre of Perinatal Excellence (COPE), Melbourne, VIC, Australia. 16. Centre for Clinical Research in Neuropsychiatry, Medical School, University of Western Australia, Perth, Australia.
Abstract
PURPOSE: The early postnatal period is a time of increased risk for psychiatric admission. However, there is scope to further examine if this increase in risk extends to the entire perinatal period (pregnancy and first postnatal year), and how it compares to admission outside of the perinatal period. METHODS: Data were linked across birth and hospital admission registers from July 2000 to December 2009. The study cohort, consisting of all pregnant and childbearing women with a psychiatric history, was divided into two groups: case women (at least one perinatal principal psychiatric admission in the study period) (38%) and comparison women (no perinatal principal psychiatric admissions) (62%). Outcomes were admission rate and length of stay adjusted for diagnosis, socio-demographic factors and timing of admission. RESULTS: Antenatal and postnatal admissions rates were both higher than non-perinatal admission rates for case women for all diagnoses. There was little evidence that women with perinatal admissions were at an increased risk of admissions at other times. Socially disadvantaged women had significantly fewer and shorter admissions than their respective counterparts. CONCLUSIONS: The entire perinatal period is a time of increased risk for admission across the range of psychiatric disorders, compared to other times in a woman's childbearing years. Reduced admission rate and length of stay for socially disadvantaged women suggest lack of equity of access highlighting the importance of national perinatal mental health policy initiatives inclusive of disadvantaged groups.
PURPOSE: The early postnatal period is a time of increased risk for psychiatric admission. However, there is scope to further examine if this increase in risk extends to the entire perinatal period (pregnancy and first postnatal year), and how it compares to admission outside of the perinatal period. METHODS: Data were linked across birth and hospital admission registers from July 2000 to December 2009. The study cohort, consisting of all pregnant and childbearing women with a psychiatric history, was divided into two groups: case women (at least one perinatal principal psychiatric admission in the study period) (38%) and comparison women (no perinatal principal psychiatric admissions) (62%). Outcomes were admission rate and length of stay adjusted for diagnosis, socio-demographic factors and timing of admission. RESULTS: Antenatal and postnatal admissions rates were both higher than non-perinatal admission rates for case women for all diagnoses. There was little evidence that women with perinatal admissions were at an increased risk of admissions at other times. Socially disadvantaged women had significantly fewer and shorter admissions than their respective counterparts. CONCLUSIONS: The entire perinatal period is a time of increased risk for admission across the range of psychiatric disorders, compared to other times in a woman's childbearing years. Reduced admission rate and length of stay for socially disadvantaged women suggest lack of equity of access highlighting the importance of national perinatal mental health policy initiatives inclusive of disadvantaged groups.
Authors: Bernard L Harlow; Allison F Vitonis; Par Sparen; Sven Cnattingius; Hadine Joffe; Christina M Hultman Journal: Arch Gen Psychiatry Date: 2007-01
Authors: Grant Sara; Luming Luo; Vaughan J Carr; Alessandra Raudino; Melissa J Green; Kristin R Laurens; Kimberlie Dean; Martin Cohen; Philip Burgess; Vera A Morgan Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2014-05-01 Impact factor: 4.328