Postpartum Mental Illness Common in Year 2

TOPLINE:

A large UK cohort study found that the prevalence of women experiencing moderate to severe mental illness in the second postpartum year increased from 3.1% to 7.4% between 1995 and 2018, supporting extended perinatal mental health (PMH) services.

METHODOLOGY:

• This retrospective cohort study analysed data of 2,132,754 pregnancies from 1,361,497 women registered with a general practitioner between 1995 and 2020 using the UK Primary Care Clinical Practice Research Datalink GOLD database.
• Women who experienced a stillbirth or termination of pregnancy or had pregnancy durations less than 24 weeks or more than 43 weeks were excluded from the analysis.
• The primary outcome was the prevalence and incidence of mental illness in the period up to 2 years after birth.

TAKEAWAY:

• The prevalence of mental illness requiring specialist PMH services in the second postpartum year increased from 3.1% in 1995 to 7.4% in 2018, with incident cases rose from 1.9% to 3.8%.
• The risk for mental illness in the second postpartum year was higher for women of most ages than for those aged 30-34 years. The risk increased with each additional pregnancy (two pregnancies vs one pregnancy: odds ratio [OR], 1.16; 95% CI, 1.13-1.19).
• Preterm births (OR, 1.21; 95% CI, 1.15-1.27), near-term births (OR, 1.21; 95% CI, 1.17-1.25), and history of mental illness (OR, 2.46; 95% CI, 2.41-2.52) were associated with an increased risk for mental illness.
• Depression and anxiety had the highest prevalence and incidence in the second postpartum year.

IN PRACTICE:

“The findings from the study indicate considerable ongoing need for specialist PMH services in the second postpartum year, supporting the extension of UK perinatal services up to two years,” the authors wrote. “Further research should explore how to improve equity in access to PMH services in the second postpartum year by facilitating and building upon culturally adapted models for screening and treatment of PMI [perinatal mental illness] for ethnic minority women,” they added.

SOURCE:

This study was led by Ellie Jones, School of Applied Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, England. It was published online on May 09 in The Lancet Regional Health – Europe.

LIMITATIONS:

This study included only women who consulted a general practitioner, possibly missing cases of moderate to severe mental illness. Some pregnancies may have been misclassified or missed due to data constraints, and loss to follow-up could have occurred if women changed practices. The severity of illness could not be precisely assessed, and some second-year cases may have been continuations of earlier illness. Additionally, social factors like support, marital status, and abuse were not included.

DISCLOSURES:

This study was funded by the National Institute for Health and Care Research Applied Research Collaboration West Midlands. Several authors reported receiving grants from the National Institute for Health and Care Research and having various ties with various organisations. Details are provided in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.