Postpartum psychosis: Risk factors identification

Upadhyaya, Suneet Kumar; Sharma, Archana; Raval, Chintan M

doi:10.4103/1947-2714.134373

Cited by 25 publications

(30 citation statements)

References 23 publications

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“…No significant differences in admission rates by age were found for the early postpartum period. This is similar to the finding by Kendell and colleagues 10 and Munk Olsen and colleagues, 11 but differs from work undertaken by others some of whom have identified an increased rate of admission due to psychotic disorder in older women 20 36 and others 15 who have reported an association between younger age and postpartum admissions. Clearly, further study in this area is merited.…”

Section: Discussionsupporting

confidence: 85%

“…Although the risk of postpartum psychosis is recognised as being highest in the first 30 days post partum, 10–14 there are gaps in our understanding of how sociodemographic factors might influence admission to hospital. 11 Studies exploring the impact of socioeconomic factors on the development of postpartum psychosis have yielded inconsistent results: some report an association between postpartum psychosis and low income, 15 16 whereas others have found no association with social class, 17 type of employment, 18 19 or educational level. 20 Even less is known about the timing of admissions due to major depression, non-affective psychosis and other mental disorders in relation to childbirth, and how sociodemographic factors might influence this.…”

Section: Introductionmentioning

confidence: 99%

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Admission to psychiatric hospital in the early and late postpartum periods: Scottish national linkage study

et al. 2016

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ObjectiveTo describe weekly admission rates for affective and non-affective psychosis, major depression and other psychiatric disorders in the early and late postpartum periods. To assess the impact of socioeconomic status, age and parity on admission rates.MethodsScottish maternity records were linked to psychiatric hospital admissions. 3290 pregnancy-related psychiatric admissions were assessed. Weekly admission rates were calculated for the pregnancy period, early postpartum period (6 weeks after birth) and late postpartum period (up to 2 years after birth), and compared with pre-pregnancy rates (up to 2 years before pregnancy). Admission rates were generated by calculating the total number of admissions for each time period divided by the number of weeks in the period. Incidence rate ratios (IRRs) were generated for each time period, using deprivation, age, parity and record of previous psychiatric hospital care-adjusted Poisson regression models.ResultsWomen from more deprived social quintiles accounted for the largest proportion of admissions across all time periods. Compared with pre-pregnancy period, admission rates fell during pregnancy, increased markedly during the early postpartum period, and remained elevated for 2 years after childbirth. Within the most affluent quintile, admission IRRs were higher in the early postpartum period (IRR=1.29, 95% CI 1.02 to 1.59) than in the late postpartum period (IRR=0.87, 95% CI 0.74 to 0.98). For the late postpartum period, there was a positive association between higher maternal age and admission IRRs (ages 20–35 years, IRR=1.35, 95% CI 1.16 to 1.54 and age>40 years IRR=1.72, 95% CI 1.41 to 2.09).ConclusionsRates of psychiatric admission fell during pregnancy and increased in the early postpartum period (particularly during the first 2 weeks after birth), and remained elevated above baseline during the 2-year late postpartum period. An understanding of how social deprivation, age and parity might influence risk of psychiatric admission at different time points could help to target perinatal mental health services more effectively.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Admission to psychiatric hospital in the early and late postpartum periods: Scottish national linkage study

et al. 2016

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“… 28 , 29 Another reason could be that, unlike the Udupi study, the present study included women with perinatal complications and chronic diseases, who are a high risk group for postpartum depression. 30 …”

Section: Discussionmentioning

confidence: 99%

Postnatal Depression among women availing maternal health services in a rural hospital in South India

Johnson¹,

Edwin²,

Joachim³

et al. 2015

Pak J Med Sci

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Background and Objective:Postnatal depression, with an estimated prevalence of 13-19%, causes significant impairment of mental health among women worldwide and has long term consequences. However, more than half of all cases are not detected by healthcare providers. Screening for postnatal depression has not been given importance in maternal health programs in India. Our objective was to screen for postnatal depression among women attending a rural hospital in India, immediately postpartum and at 6-8 weeks post-delivery, and to study associated factors.Methods:A cross sectional study was done on 123 postnatal women attending a rural maternity hospital in Karnataka, South India, of whom 74 women were interviewed within one week of childbirth, and 49 women at 6-8 weeks post-delivery. The Edinburgh Postnatal Depression Scale was used to screen for postnatal depression.Results:About 45.5% of the women screened positive for postnatal depression (44.6% of all subjects within one week of delivery and 46.9% at 6-8 weeks after delivery). Postnatal depression was significantly associated with mood swings during antenatal period, staying with the family of birth during pregnancy and away from their husbands, and was significantly higher among women who perceived their life as stressful and having a low self-esteem (P<0.05)Conclusions:This study found a high prevalence of postnatal depression in women in rural Karnataka. This underlines the need for incorporating screening for postnatal depression in the routine care of women during pregnancy and delivery.

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“…During the postnatal period, women may develop psychological disorders that can range in severity from ‘baby blues’ (15% to 80% of women) to postpartum depression to puerperal psychosis 1–18. The prevalence of postpartum depression in the general population has been estimated to vary from 10% to 20% 9–16.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of maternal psychological disorders after immediate postpartum haemorrhage: a repeated cross-sectional study - the PSYCHE* study protoco

Pranal

Legrand

Chazeron³

et al. 2019

BMJ Open

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IntroductionThe main objective of this study is to assess the prevalence of depression at 2, 6 and 12 months postpartum in women who have had an immediate postpartum haemorrhage (PPH) (blood loss ≥500 mL within 24 hours of delivery). The secondary objectives are to assess the prevalence of anxiety and post-traumatic stress disorder among these women and to evaluate the prevalence of psychological disorders according to the severity of the PPH.Methods and analysisThis repeated, cross-sectional, single-centre study will take place at the Clermont-Ferrand University Hospital (France). The population will comprise a cohort of women giving birth at a term ≥22 weeks of gestation.For each woman with a PPH (exposed), two women without PPH (unexposed) will be included: the women who give birth immediately before and immediately after her. The PPH will be managed according to French guidelines. The principal endpoint is the prevalence of depression, measured by the Edinburgh Postnatal Depression Scale (EPDS). The intervention will consist of four surveys including various self-completed questionnaires: the first during the immediate postpartum (Post-Delivery Perceived Stress Inventory (PDPSI), Spielberger'sState-Trait Anxiety Inventory (STAI)-Y-A and Y-B and Mini-International Neuropsychiatric Interview (M.I.N.I.) 5.0.0), then at 2 months (EPDS, STAI-Y-A, Generalised Anxiety Disorder (GAD-7) and Revised Impact of Event Scale (IES-R)), and finally at 6 months and 1 year postpartum (EPDS, STAI-Y-A, GAD-7, M.I.N.I. 5.0.0 and IES-R). The study will include 1542 women — 514 with PPH.Ethics and disseminationThe institutional review board (IRB) approved the study on 14 February 2017 (IRB Sud Est VI: N°AU1243).Results will be reported in peer-reviewed journals and at scientific meetings. Findings from the study will be useful for individualising medical follow-up after childbirth, especially for woman who experienced a PPH, but also more generally in increasing birth professionals' awareness of effects of trauma. The evidence obtained might also lead to modifying practices and including this recommendation in French guidelines on PPH.Trial registration numberNCT03120208.

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Postpartum psychosis: Risk factors identification

Cited by 25 publications

References 23 publications

Admission to psychiatric hospital in the early and late postpartum periods: Scottish national linkage study

Admission to psychiatric hospital in the early and late postpartum periods: Scottish national linkage study

Postnatal Depression among women availing maternal health services in a rural hospital in South India

Prevalence of maternal psychological disorders after immediate postpartum haemorrhage: a repeated cross-sectional study - the PSYCHE* study protoco

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