Patterns of psychiatric admission in Australian pregnant and childbearing women

• Published in: Social Psychiatry and Psychiatric Epidemiology 2022-03, Vol.57 (3), p.611-621
• Main Authors: Austin, Marie-Paule, Ambrosi, Taryn L., Reilly, Nicole, Croft, Maxine, Hutchinson, Jolie, Donnolley, Natasha, Mihalopoulos, Cathrine, Chatterton, Mary Lou, Chambers, Georgina M., Sullivan, Elizabeth, Knox, Catherine, Xu, Fenglian, Highet, Nicole, Morgan, Vera A.
• Format: Article
• Language: English
• Subjects: Analysis; Epidemiology; Length of stay; Medical policy; Medicine; Medicine & Public Health; Mental health; Mental illness; Original Paper; Pregnancy; Pregnant women; Psychiatry; Risk
• ISSN: 0933-7954; 1433-9285
• DOI: 10.1007/s00127-021-02137-2

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.