TY - JOUR
T1 - Patterns of psychiatric admission in Australian pregnant and childbearing women
AU - Austin, Marie Paule
AU - Ambrosi, Taryn L.
AU - Reilly, Nicole
AU - Croft, Maxine
AU - Hutchinson, Jolie
AU - Donnolley, Natasha
AU - Mihalopoulos, Cathrine
AU - Chatterton, Mary Lou
AU - Chambers, Georgina M.
AU - Sullivan, Elizabeth
AU - Knox, Catherine
AU - Xu, Fenglian
AU - Highet, Nicole
AU - Morgan, Vera A.
N1 - Funding Information:
The current study was funded by a National Health and Medical Research Council (NHMRC) partnership grant [APP1028554]: ‘The Australian Perinatal Mental Health Reforms: using Population Data to Evaluate their Impact on Service Utilisation and Related Cost-Effectiveness’. Beyondblue is a funding partner on this grant. Professor Marie-Paule Austin, Dr Georgina Chambers, Associate Professor Maxine Croft, Dr Nicole Highet, Associate Professor Cathrine Mihalopoulos, Professor Vera Morgan and Professor Elizabeth Sullivan, are Chief Investigators on the above Grant. Professor Marie-Paule Austin’s chair is funded by St John of God Healthcare, who also provided generous infrastructure support. Associate Professor Cathrine Mihalopoulos was funded by a NHMRC Early Career Research Grant [1035887] at the time of this study. Dr Nicole Highet was the former Deputy CEO and National Perinatal Advisor of beyondblue between 2001 and 2013.
Funding Information:
The study was funded by a National Health and Medical Research Council (NHMRC) partnership grant [APP1028554]: ?The Australian Perinatal Mental Health Reforms: Using Population Data to Evaluate their Impact on Service Utilisation and Related Cost-Effectiveness? with beyondblue as the funding partner. The authors thank staff of the Western Australia Department of Health and the Centre for Health Record Linkage (CHeReL) for the provision of data. We acknowledge the families who have contributed their data and professional staff involved in the data collection. Thanks to Damian McGuckin from Pacific ESI who built the platform for merging of datasets across NSW and WA; and to research assistants Kate Brameld and Sharon Vukovich and statistician Dusan Hadzi-Pavlovic for assistance with early data advice. Finally, our thanks to Zac Steel for his careful reading and feedback of our revised manuscript.
Publisher Copyright:
© 2021, Crown.
PY - 2022/3
Y1 - 2022/3
N2 - 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.
AB - 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.
KW - Postnatal
KW - Pregnancy
KW - Psychiatric admission
KW - Record linkage
UR - http://www.scopus.com/inward/record.url?scp=85111099354&partnerID=8YFLogxK
U2 - 10.1007/s00127-021-02137-2
DO - 10.1007/s00127-021-02137-2
M3 - Article
C2 - 34292361
AN - SCOPUS:85111099354
SN - 0933-7954
VL - 57
SP - 611
EP - 621
JO - Social Psychiatry and Psychiatric Epidemiology
JF - Social Psychiatry and Psychiatric Epidemiology
IS - 3
ER -