Postpartum Psychiatric Outcomes following Severe Maternal Morbidity in an Urban Safety-Net Hospital. 2024

Alayna H Feng, and Kaitlyn K Stanhope, and Denise J Jamieson, and Sheree L Boulet
Department of Epidemiology, Rollins School of Public Health, Atlanta, Georgia.

OBJECTIVE Severe maternal morbidity (SMM) may be associated with postpartum psychiatric morbidity. However, the direction and strength of this relationship remain unclear. Our goal was to estimate the association between SMM and postpartum inpatient mental health care utilization. METHODS We examined all liveborn deliveries at a large, safety-net hospital in Atlanta, Georgia, from 2013 to 2021. SMM at or within 42 days of delivery was identified using International Classification of Disease codes. The primary outcome of interest was hospitalization with a psychiatric diagnosis in the year following the delivery. We used inverse probability of treatment weighting based on propensity scores to adjust for demographics, index delivery characteristics, and medical, psychiatric, and obstetric history. We fit log-binomial models with generalized estimating equations to calculate adjusted risk ratios (aRRs) and 95% confidence intervals (CIs). RESULTS Among 22,233 deliveries, the rates of SMM and postpartum hospitalization with a psychiatric diagnosis, respectively, were 6.8% (n = 1,149) and 0.8% (n = 169). The most common psychiatric diagnosis was nonpsychotic mood disorders (without SMM 0.4%, n = 79; with SMM 1.7% n = 24). After weighting, 2.2% of deliveries with SMM had a postpartum readmission with a psychiatric diagnosis, compared with 0.7% of deliveries without SMM (aRR: 3.2, 95% CI: [2.0, 5.2]). Associations were stronger among individuals without previous psychiatric hospitalization. CONCLUSIONS Experiencing SMM was associated with an elevated risk of postpartum psychiatric morbidity. These findings support screening and treatment for mild and moderate postpartum psychiatric disorders in the antenatal period. CONCLUSIONS · Experiencing SMM was associated with three-fold excess risk of postpartum psychiatric admission.. · Experiencing SMM was not associated with an elevated risk of outpatient psychiatric care use.. · Experience SMM was not associated with outpatient psychiatric morbidity diagnoses..

UI MeSH Term Description Entries
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011248 Pregnancy Complications Conditions or pathological processes associated with pregnancy. They can occur during or after pregnancy, and range from minor discomforts to serious diseases that require medical interventions. They include diseases in pregnant females, and pregnancies in females with diseases. Adverse Birth Outcomes,Complications, Pregnancy,Adverse Birth Outcome,Birth Outcome, Adverse,Complication, Pregnancy,Outcome, Adverse Birth,Pregnancy Complication
D011644 Puerperal Disorders Disorders or diseases associated with PUERPERIUM, the six-to-eight-week period immediately after PARTURITION in humans. Disorder, Puerperal,Disorders, Puerperal,Puerperal Disorder
D005260 Female Females
D005845 Georgia A state located in the southeastern United States, The capital is Atlanta.
D006760 Hospitalization The confinement of a patient in a hospital. Hospitalizations
D006786 Hospitals, Urban Hospitals located in metropolitan areas. City Hospitals,Hospitals, City,Hospitals, City, Non-Public-Owned,Hospitals, Metropolitan,Urban Hospitals,City Hospitals, Non-Public-Owned,Metropolitan Hospitals,Non-Public-Owned City Hospitals,City Hospital,City Hospital, Non-Public-Owned,City Hospitals, Non Public Owned,Hospital, City,Hospital, Metropolitan,Hospital, Non-Public-Owned City,Hospital, Urban,Hospitals, Non-Public-Owned City,Metropolitan Hospital,Non Public Owned City Hospitals,Non-Public-Owned City Hospital,Urban Hospital
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001523 Mental Disorders Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. Mental Illness,Psychiatric Diseases,Psychiatric Disorders,Psychiatric Illness,Behavior Disorders,Diagnosis, Psychiatric,Mental Disorders, Severe,Psychiatric Diagnosis,Illness, Mental,Mental Disorder,Mental Disorder, Severe,Mental Illnesses,Psychiatric Disease,Psychiatric Disorder,Psychiatric Illnesses,Severe Mental Disorder,Severe Mental Disorders

Related Publications

Alayna H Feng, and Kaitlyn K Stanhope, and Denise J Jamieson, and Sheree L Boulet
March 2022, American journal of obstetrics & gynecology MFM,
Alayna H Feng, and Kaitlyn K Stanhope, and Denise J Jamieson, and Sheree L Boulet
December 2020, American journal of epidemiology,
Alayna H Feng, and Kaitlyn K Stanhope, and Denise J Jamieson, and Sheree L Boulet
August 2021, American journal of perinatology,
Alayna H Feng, and Kaitlyn K Stanhope, and Denise J Jamieson, and Sheree L Boulet
July 2020, AJP reports,
Alayna H Feng, and Kaitlyn K Stanhope, and Denise J Jamieson, and Sheree L Boulet
February 2023, American journal of obstetrics & gynecology MFM,
Alayna H Feng, and Kaitlyn K Stanhope, and Denise J Jamieson, and Sheree L Boulet
March 2012, Iranian journal of reproductive medicine,
Alayna H Feng, and Kaitlyn K Stanhope, and Denise J Jamieson, and Sheree L Boulet
March 2022, American journal of obstetrics & gynecology MFM,
Alayna H Feng, and Kaitlyn K Stanhope, and Denise J Jamieson, and Sheree L Boulet
January 2021, Journal of health care for the poor and underserved,
Alayna H Feng, and Kaitlyn K Stanhope, and Denise J Jamieson, and Sheree L Boulet
August 2006, American journal of perinatology,
Alayna H Feng, and Kaitlyn K Stanhope, and Denise J Jamieson, and Sheree L Boulet
September 2019, Journal of perinatology : official journal of the California Perinatal Association,
Copied contents to your clipboard!