First lifetime psychiatric admission in the postpartum period: A population-based comparison to women with prior psychiatric admission

Polachek, Inbal Shlomi; Fung, Kinwah; Vigod, Simone N.

doi:10.1016/j.genhosppsych.2016.01.007

Cited by 14 publications

(11 citation statements)

References 33 publications

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“…We also did not measure all types of service use for mental illness, such as emergency department visits and hospitalizations. Although utilization of acute care services for postpartum mental illness is generally low (in the range of 2 to 5 per 1000 births), 28,29 if needs go unmet despite increased outpatient visit rates, higher acute care use could result over time. Future research should identify ongoing clinical burden as the pandemic progresses.…”

Section: Discussionmentioning

confidence: 99%

Postpartum mental illness during the COVID-19 pandemic: a population-based, repeated cross-sectional study

Vigod

Brown

Huang

et al. 2021

CMAJ

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Postpartum mental illness affects as many as 1 in 5 mothers, 1 and can result in maternal suffering and diminished functioning. 2 Related impaired mother-infant interactions are linked to poor social, cognitive and behavioural outcomes in children across their lifespan. 3 When mental illness becomes chronic and recurrent, its effects can extend to the entire family and across generations. 4 With emergence of the novel coronavirus (SARS-CoV-2), the World Health Organization declared a global COVID-19 pandemic on Mar. 11, 2020. Globally, efforts to contain the virus have led to widespread travel restrictions, physical distancing and work limitations, causing broad social and financial disruption that has been associated with substantial mental health effects. 5,6 During the COVID-19 pandemic, people have been reporting concerns about postpartum infection, 7 and difficulty accessing the extended postpartum social support networks and key community programs that protect against mental illness, such as home visits from public health nurses, breastfeeding clinics and support groups, owing to public health measures. 8 In Canadian surveys, about 50% of pregnant people reported psychological distress in spring 2020, 9 and alcohol use increased among women, particularly among those with young children. 10 Whether this represents an increased clinical burden of mental illness or need for care is unknown.Using routinely collected health care data from Ontario, Canada, (population of about 14.6 million), we aimed to examine RESEARCHMENTAL HEALTH

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Section: Discussionmentioning

confidence: 99%

Postpartum mental illness during the COVID-19 pandemic: a population-based, repeated cross-sectional study

Vigod

Brown

Huang

et al. 2021

CMAJ

Self Cite

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“…We will retrospectively evaluate adverse pregnancy outcomes among Ontario women physicians and nonphysicians of reproductive age who have experienced at least one childbirth >20 weeks GA. All outcomes of interest were chosen for their clinical relevance and established methodology for ascertainment from ICES databases such as MOMBABY, DAD and OHIP, using standard diagnostic and procedural codes [46][47][48][49][50][51][52][53][54] (see online supplemental table 3).…”

Section: Discussionmentioning

confidence: 99%

“…and/or Ontario-specific algorithms to ensure accuracy [46][47][48][49][50][51][52][53][54] ; and have used databases that are validated 55 56 or periodically reabstracted. 57 Aim 1: compare reproductive patterns in women physicians and non-physicians Rationale and overview Numerous survey-based studies suggest that women physicians frequently delay childbearing and subsequently experience a higher rate of infertility compared with the general population.…”

Section: Open Accessmentioning

confidence: 99%

Reproductive patterns, pregnancy outcomes and parental leave practices of women physicians in Ontario, Canada: the Dr Mom Cohort Study protocol

et al. 2020

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IntroductionSurveys and qualitative studies suggest that women physicians may delay childbearing, be at increased risk of adverse peripartum complications when they do become pregnant, and face discrimination and lower earnings as a result of parenthood. Observational studies enrolling large, representative samples of women physicians are needed to accurately evaluate their reproductive patterns, pregnancy outcomes, parental leave practices and earnings. This protocol provides a detailed research plan for such studies.Methods and analysisThe Dr Mom Cohort Study encompasses a series of retrospective observational studies of women physicians in Ontario, Canada. All practising physicians in Ontario are registered with the College of Physicians and Surgeons of Ontario (CPSO). By linking a dataset of physicians from the CPSO to existing provincial administrative databases, which hold health data and physician billing records, we will be able to retrospectively assess the healthcare utilisation, work practices and pregnancy outcomes of women physicians at the population level. Specific outcomes of interest include: (1) rates and timing of pregnancy; (2) pregnancy-related care and complications; and (3) duration of parental leave and subsequent earnings, each of which will be evaluated with regression methods appropriate to the form of the outcome. We estimate that, at minimum, 5000 women physicians will be eligible for inclusion.Ethics and disseminationThis protocol has been approved by the Research Ethics Board at St. Michael’s Hospital in Toronto, Ontario, Canada (#18–248). We will disseminate findings through several peer-reviewed publications, presentations at national and international meetings, and engagement of physicians, residency programmes, department heads and medical societies.

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“…These risk factors have previously been identified with psychiatric illness and admissions. 8,[23][24][25] These findings suggest that social factors may additionally be associated with psychiatric-related admission. Younger patients, those receiving public insurance, and fewer resources may be important subgroups in targeting support services.…”

Section: Discussionmentioning

confidence: 80%

Postpartum Psychiatric Admissions in the United States

et al. 2019

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Objective To assess risk for postpartum psychiatric admissions in the United States. Study Design This study used the 2010 to 2014 Nationwide Readmissions Database to identify psychiatric admissions during the first 60 days after delivery hospitalization. Timing of admission after delivery discharge was determined. We fit multivariable log-linear regression models to assess the impact of psychiatric comorbidity on admission risk, adjusting for patient, obstetrical, and hospital factors. Results Of 15.7 million deliveries from 2010 to 2014, 11,497 women (0.07%) were readmitted for a primary psychiatric diagnosis within 60 days postpartum. Psychiatric admissions occurred relatively consistently across 10-day periods after delivery hospitalization discharge. Psychiatric diagnoses were present among 5% of women at delivery but 40% of women who were readmitted postpartum for a psychiatric indication. In the adjusted model, women with psychiatric diagnoses at delivery hospitalization were 9.7 times more likely to be readmitted compared with those without psychiatric comorbidity. Women at highest risk for psychiatric admission were those with Medicare and Medicaid, in lower income quartiles, and of younger age. Conclusion While a large proportion of psychiatric admissions occurred among a relatively small proportion of at-risk women, admissions occurred over a broad temporal period relative to other indications for postpartum admission.

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First lifetime psychiatric admission in the postpartum period: A population-based comparison to women with prior psychiatric admission

Cited by 14 publications

References 33 publications

Postpartum mental illness during the COVID-19 pandemic: a population-based, repeated cross-sectional study

Postpartum mental illness during the COVID-19 pandemic: a population-based, repeated cross-sectional study

Reproductive patterns, pregnancy outcomes and parental leave practices of women physicians in Ontario, Canada: the Dr Mom Cohort Study protocol

Postpartum Psychiatric Admissions in the United States

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