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Adhikary S, Gillespie K, Kimball H, Healey L, Webb O, Balram A, Branjerdporn G. A systematic review of research examining mothers, infants, family and staff in psychiatric mother-baby units. Acta Psychiatr Scand 2024. [PMID: 38958035 DOI: 10.1111/acps.13727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/07/2024] [Accepted: 06/22/2024] [Indexed: 07/04/2024]
Abstract
OBJECTIVE This systematic review aimed to summarise and synthesise research conducted in psychiatric mother-baby units (MBUs) in relation to patients, their families, or staff, published from 1st January 2016 to 1st May 2024. METHOD Quantitative, qualitative, and mixed-method studies were included for review if they were published in peer-review journals in English and reported research on MBUs between January 2016 and May 2024. From the initial yield of 10,007 unique studies, 53 studies were included for review. RESULTS MBU research was found to more frequently investigate maternal characteristics rather than the benefits of MBU treatment compared to studies conducted prior to 2016. Most studies that did investigate impact of admission showed favourable results, however few follow-up studies and studies comparing MBU outcomes to other clinical settings were undertaken. Little research has been conducted to investigate the differential impacts of MBU admission on different diagnoses and long-term (>1 year) patient outcomes. There was a dearth of research investigating partners of women in MBUs and few studies conducted on infant outcomes. CONCLUSIONS MBUs were consistently found to improve mental health systems and mother-infant attachment in patients after admission. More research investigating patient support networks and child health, impact of diagnosis on outcomes, and studies with adequate follow-up are required.
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Affiliation(s)
- Sam Adhikary
- Mater Young Adult Health Centre, Catherine's House for Mothers, Babies and Families, Mater Hospital, Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Kerri Gillespie
- Mater Young Adult Health Centre, Catherine's House for Mothers, Babies and Families, Mater Hospital, Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Hayley Kimball
- Mater Young Adult Health Centre, Catherine's House for Mothers, Babies and Families, Mater Hospital, Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Lyndall Healey
- Mental Health and Specialist Services, Gold Coast University Hospital, Gold Coast Hospital and Health Service, Queensland Health, Gold Coast, Queensland, Australia
| | - Olivia Webb
- Mental Health and Specialist Services, Gold Coast University Hospital, Gold Coast Hospital and Health Service, Queensland Health, Gold Coast, Queensland, Australia
| | - Abha Balram
- Mental Health and Specialist Services, Gold Coast University Hospital, Gold Coast Hospital and Health Service, Queensland Health, Gold Coast, Queensland, Australia
| | - Grace Branjerdporn
- Mater Young Adult Health Centre, Catherine's House for Mothers, Babies and Families, Mater Hospital, Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Mental Health and Specialist Services, Gold Coast University Hospital, Gold Coast Hospital and Health Service, Queensland Health, Gold Coast, Queensland, Australia
- Faculty of Health Sciences & Medicine, Bond University, Robina, Australia
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Runkle JD, Risley K, Roy M, Sugg MM. Association Between Perinatal Mental Health and Pregnancy and Neonatal Complications: A Retrospective Birth Cohort Study. Womens Health Issues 2023; 33:289-299. [PMID: 36621340 PMCID: PMC10213085 DOI: 10.1016/j.whi.2022.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 11/30/2022] [Accepted: 12/09/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Maternal mental health as an important precursor to reproductive and neonatal complications remains understudied in the United States, particularly in the Southeastern region, despite high medical costs, maternal morbidity, and infant burden. This study sought to estimate the incidence of perinatal mental health disorders and the associated increased risk of leading pregnancy and infant complications. METHODS A population-based retrospective birth cohort of childbirth hospitalizations and readmissions was constructed for women in South Carolina, 1999 to 2017. Prevalence rates were calculated for perinatal mood and anxiety disorders (PMAD), severe mental illness, and mental disorders of pregnancy (MDP). Poisson regression models using generalized estimating equations were used to estimate adjusted relative risks for the association between mental health conditions and severe maternal morbidity, hypertensive disorders of pregnancy, gestational diabetes, cesarean section, preterm birth, and low birthweight. RESULTS The most prevalent maternal mental condition was MDP (3.9%), followed by PMAD (2.7%) and severe mental illness (0.13%). PMAD was associated with a higher risk of severe maternal morbidity, hypertensive disorders of pregnancy, and cesarean section, as well as a higher risk of preterm birth and low birthweight infants. Severe mental illness was associated with low birthweight, hypertensive disorders of pregnancy, and cesarean section. Pregnant populations with MDP were more at risk for severe maternal morbidity, preterm birth, hypertensive disorders of pregnancy, low birthweight, and cesarean section. Each maternal mental health outcome was associated with an increased risk for hospital readmissions up to 45 days after childbirth. CONCLUSIONS Results demonstrate the escalating burden of PMAD and MDP for pregnant populations over time, with important consequences related to maternal and infant morbidity.
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Affiliation(s)
- Jennifer D Runkle
- North Carolina Institute for Climate Studies, North Carolina State University, Asheville, North Carolina.
| | - Kendra Risley
- North Carolina Institute for Climate Studies, North Carolina State University, Asheville, North Carolina
| | - Manan Roy
- Department of Nutrition and Health Care Management, Appalachian State University, Boone, North Carolina
| | - Margaret M Sugg
- Department of Geography and Planning, Appalachian State University, Boone, North Carolina
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Avis d’experts français sur la prise en charge des femmes en âge de procréer et enceintes souffrant d’un trouble bipolaire traitées par valproate. L'ENCEPHALE 2022; 48:624-631. [DOI: 10.1016/j.encep.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/30/2022] [Accepted: 07/15/2022] [Indexed: 11/19/2022]
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Accortt E, Mirocha J, Jackman S, Coussons-Read M, Dunkel Schetter C, Hobel C. Association between diagnosed perinatal mood and anxiety disorders and adverse perinatal outcomes. J Matern Fetal Neonatal Med 2022; 35:9066-9070. [PMID: 34879772 PMCID: PMC10024940 DOI: 10.1080/14767058.2021.2014450] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To determine whether a diagnosis of a perinatal mood and anxiety disorder (PMAD) is associated with adverse perinatal outcomes. METHODS Mental health symptom screening and diagnostic data from 82 women with single gestation in the Healthy Babies Before Birth study conducted from 2013 to 2018 were obtained by clinic interview. If a woman scored over 10 on the Patient Health Questionnaire (PHQ-9) or endorsed the suicidality item; or scored over 7 on the Overall Anxiety Severity and Impairment Scale (OASIS), a Structured Clinical Interview for DSM-IV (SCID) Axis I Disorders was administered. An adverse perinatal outcome was operationalized as a diagnosis of gestational diabetes mellitus, intrauterine growth restriction, preeclampsia, chorioamnionitis, hemorrhage, fetal death, preterm birth, or a low birthweight baby, and abstracted from the medical records. RESULTS Women were between 22.0 and 45.0 years old (Mean age = 33.1 ± 4.3). Mean BMI was 24.7 ± 5.6 (Range 16.8 to 47.1). Nineteen percent (16) of the 82 women had a SCID diagnosis of a PMAD. Thirty-seven percent (30) had a diagnosed adverse perinatal outcome. Multiple logistic regression was conducted with these predictors: SCID diagnosis of a PMAD, maternal age, BMI. All predictors were significant with respective odds ratios as follows: OR = 3.58, 95% CI 1.03-12.44, p = .045; OR = 2.30, 95% CI 1.21-4.38, p = .011; OR = 1.69, 95% CI 1.06-2.69, p = .027. CONCLUSIONS A PMAD diagnosis was associated with 3.5 times higher odds of having an adverse perinatal outcome. For every 5 years a woman aged or every five units her BMI increased her odds of having an adverse perinatal outcome increased. Older age and increased BMI are well established adverse perinatal outcome risk factors. These results suggest that mental illness risk should also be consistently assessed in obstetric settings.
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Affiliation(s)
- Eynav Accortt
- Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - James Mirocha
- Cedars-Sinai Biostatistics Core, Research Institute, Clinical and Translational Science Institute (CTSI), Clinical and Translational Research Center (CTRC), Los Angeles, CA, USA
| | - Susan Jackman
- Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Mary Coussons-Read
- Department of Psychology, University of Colorado, Colorado Springs, CO, USA
| | | | - Calvin Hobel
- Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Suicide maternel périnatal : comment prévenir ? Encephale 2022; 48:590-592. [DOI: 10.1016/j.encep.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/04/2022] [Accepted: 01/05/2022] [Indexed: 10/18/2022]
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Soares MC, de Matos MB, da Cunha GK, Leite CF, Caruccio HS, Trettim JP, Scholl CC, Rubin BB, Coelho FMDC, Quevedo LDA, Pinheiro RT, Pinheiro KAT. Suicide risk and prematurity: A study with pregnant adolescents. J Psychiatr Res 2021; 133:125-133. [PMID: 33340791 DOI: 10.1016/j.jpsychires.2020.12.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 11/03/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To verify the association between mood and anxiety disorders, and suicide risk during pregnancy and their relationship with premature birth in a population of pregnant adolescents attending prenatal care in the public health system of Pelotas, a southern city in Brazil. METHODS This was a cohort study with all pregnant adolescents attending antenatal public services in the urban area of Pelotas between October 2009 and May 2011. The first assessment occurred between the 20th and 22 nd week of pregnancy and the second occurred one month after delivery. We used the Mini International Neuropsychiatric Interview (MINI) to assess mood and anxiety disorders and suicide risk. RESULTS A total of 645 pregnant women aged between 12 and 19 years old were interviewed. An anxiety disorder was present in 9.1% of the pregnant adolescent, and 28.5% had a mood disorder. The prevalence of suicide risk was 12.6%, and 15.3% of the babies were born premature. A multivariate analysis adjusted for maternal education, number of previous pregnancies and previous preterm birth indicated that adolescents who had suicide risk during pregnancy were approximately twice as likely to give birth prematurely when compared to those who were not diagnosed with suicide risk (PR 1.79; CI 1.06-3.03). CONCLUSION Our findings suggest that pregnant adolescents who were at risk of suicide during pregnancy were more likely to have premature babies. It is important to pay attention to the mental health of this specific population to prevent obstetric complications and consequently improve the health of the children.
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Affiliation(s)
- Mariana Carret Soares
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas (UCPel), Pelotas, RS, Brazil
| | - Mariana Bonati de Matos
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas (UCPel), Pelotas, RS, Brazil
| | - Gabriela Kurz da Cunha
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas (UCPel), Pelotas, RS, Brazil
| | - Ciciliane Foster Leite
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas (UCPel), Pelotas, RS, Brazil
| | - Henrique Seus Caruccio
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas (UCPel), Pelotas, RS, Brazil
| | - Jéssica Puchalski Trettim
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas (UCPel), Pelotas, RS, Brazil
| | - Carolina Coelho Scholl
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas (UCPel), Pelotas, RS, Brazil
| | - Bárbara Borges Rubin
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas (UCPel), Pelotas, RS, Brazil
| | | | - Luciana de Avila Quevedo
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas (UCPel), Pelotas, RS, Brazil
| | - Ricardo Tavares Pinheiro
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas (UCPel), Pelotas, RS, Brazil.
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McKee K, Admon LK, Winkelman TNA, Muzik M, Hall S, Dalton VK, Zivin K. Perinatal mood and anxiety disorders, serious mental illness, and delivery-related health outcomes, United States, 2006-2015. BMC WOMENS HEALTH 2020; 20:150. [PMID: 32703202 PMCID: PMC7376899 DOI: 10.1186/s12905-020-00996-6] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 06/18/2020] [Indexed: 11/06/2022]
Abstract
Background National estimates of perinatal mood and anxiety disorders (PMAD) and serious mental illness (SMI) among delivering women over time, as well as associated outcomes and costs, are lacking. The prevalence of perinatal mood and anxiety disorders and serious mental illness from 2006 to 2015 were estimated as well as associated risk of adverse obstetric outcomes, including severe maternal morbidity and mortality (SMMM), and delivery costs. Methods The study was a serial, cross-sectional analysis of National Inpatient Sample data. The prevalence of PMAD and SMI was estimated among delivering women as well as obstetric outcomes, healthcare utilization, and delivery costs using adjusted weighted logistic with predictive margins and generalized linear regression models, respectively. Results The study included an estimated 39,025,974 delivery hospitalizations from 2006 to 2015 in the U.S. PMAD increased from 18.4 (95% CI 16.4–20.0) to 40.4 (95% CI 39.3–41.6) per 1000 deliveries. SMI also increased among delivering women over time, from 4.2 (95% CI 3.9–4.6) to 8.1 (95% CI 7.9–8.4) per 1000 deliveries. Medicaid covered 72% (95% CI 71.2–72.9) of deliveries complicated by SMI compared to 44% (95% CI 43.1–45.0) and 43.5% (95% CI 42.5–44.5) among PMAD and all other deliveries, respectively. Women with PMAD and SMI experienced higher incidence of SMMM, and increased hospital transfers, lengths of stay, and delivery-related costs compared to other deliveries (P < .001 for all). Conclusion Over the past decade, the prevalence of both PMAD and SMI among delivering women increased substantially across the United States, and affected women had more adverse obstetric outcomes and delivery-related costs compared to other deliveries.
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Affiliation(s)
- Kimberly McKee
- Department of Family Medicine, University of Michigan, 1018 Fuller Street, Ann Arbor, MI, 48104-1213, USA.
| | - Lindsay K Admon
- Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, USA.,University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, USA.,Program on Women's Healthcare Effectiveness Research, University of Michigan, Ann Arbor, MI, USA
| | - Tyler N A Winkelman
- Division of General Internal Medicine, Hennepin Healthcare, Minneapolis, MN, USA.,Hennepin Healthcare Research Institute, Minneapolis, MN, USA
| | - Maria Muzik
- Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, USA.,University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, USA.,Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Stephanie Hall
- Department of Learning Health Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Vanessa K Dalton
- Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, USA.,University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, USA.,Program on Women's Healthcare Effectiveness Research, University of Michigan, Ann Arbor, MI, USA
| | - Kara Zivin
- University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI, USA.,Program on Women's Healthcare Effectiveness Research, University of Michigan, Ann Arbor, MI, USA.,Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.,VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.,Department of Health Policy & Management, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Belzeaux R, Sanguinetti C, Murru A, Verdolini N, Pacchiarotti I, Hidalgo-Mazzei D, Cohen L, Anmella G, Barbuti M, Vieta E, Llorca PM, Samalin L. Pharmacotherapy for the peripartum management of bipolar disorder. Expert Opin Pharmacother 2019; 20:1731-1741. [PMID: 31159601 DOI: 10.1080/14656566.2019.1626826] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Introduction: The peripartum period in bipolar disorder (BD) patients is associated with high risk of relapse. Relapse during this period may affect fetal and child development. The consequences of psychotropic medication during pregnancy are also a major concern. The extent to which mood stabilizers may potentially affect the embryogenesis or the child development varies from high (e.g. valproate) to less clear and more debated (e.g. lithium). Areas covered: This review describes the current state of evidence with respect to the impact of recommended pharmacological interventions for BD during the peripartum period. It compares recent international treatment guidelines for the management of BD during the peripartum period. Last, this review presents a summary of key recommendations for BD women of childbearing age, for BD women during pregnancy and postpartum period from the international guidelines. Expert opinion: Management of the pharmacological treatment for BD patients during the perinatal period is challenging. Although treatment guidelines may be of significant help, high heterogeneity exists across them. Shared decision-making represents a useful patient-centered approach during the perinatal period. Large cohort studies are needed to better identify risk associated to treatment discontinuation or treatment exposure.
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Affiliation(s)
- Raoul Belzeaux
- APHM, Department of psychiatry and INT-UMR7289, CNRS Aix Marseille University , Marseille , France.,Fondation FondaMental , Créteil , France
| | - Catherine Sanguinetti
- APHM, Department of psychiatry and INT-UMR7289, CNRS Aix Marseille University , Marseille , France
| | - Andrea Murru
- Bipolar and Depression Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM , Barcelona , Catalonia , Spain
| | - Norma Verdolini
- Bipolar and Depression Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM , Barcelona , Catalonia , Spain.,FIDMAG Germanes Hospitalaries Research Foundation , Barcelona , Catalonia , Spain.,Division of Psychiatry, Clinical Psychology and Rehabilitation, University of Perugia , Perugia , Italy
| | - Isabella Pacchiarotti
- Bipolar and Depression Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM , Barcelona , Catalonia , Spain
| | - Diego Hidalgo-Mazzei
- Bipolar and Depression Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM , Barcelona , Catalonia , Spain
| | - Lola Cohen
- APHM, Department of psychiatry and INT-UMR7289, CNRS Aix Marseille University , Marseille , France
| | - Gerard Anmella
- Bipolar and Depression Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM , Barcelona , Catalonia , Spain
| | - Margherita Barbuti
- Department of Experimental and Clinic Medicine, Section of Psychiatry, University of Pisa , Pisa , Italy
| | - Eduard Vieta
- Bipolar and Depression Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM , Barcelona , Catalonia , Spain
| | - Pierre-Michel Llorca
- Fondation FondaMental , Créteil , France.,Department of Psychiatry, CHU Clermont-Ferrand and University of Clermont Auvergne, EA 7280 , Clermont-Ferrand , France
| | - Ludovic Samalin
- Fondation FondaMental , Créteil , France.,Department of Psychiatry, CHU Clermont-Ferrand and University of Clermont Auvergne, EA 7280 , Clermont-Ferrand , France
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