Major depressive disorder in the perinatal period: using data linkage to inform perinatal mental health policy
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This study aims to investigate hospital admission of major depressive disorders (MDD) before and after birth. Population data for all primiparous women admitted to the hospital with depressive disorders before and after birth were used. The comparison group consisted of 10 % of primiparous women not admitted to the hospital with a diagnosis of a psychiatric disorder or substance use. A total of 728 women had a first admission with depressive disorders (501 in the first postpartum year). The rate of first hospital admission for depressive disorders decreased during pregnancy and increased markedly in the first three months after birth (peaking in the second month with a rate of 10.74/1,000 person year and rate ratio of 12.56) compared with the 6 months prior to pregnancy. Admission remained elevated in the second postpartum year. Older maternal age, smoking, elective caesarian section and admission to a neonatal intensive care unit or special care nursery were associated with a higher rate of admission. Women born outside Australia and those most socioeconomically disadvantaged were less likely to be admitted to the hospital in the first postpartum year. Overall risk of hospital admission with depressive disorders rose significantly across the entire first postpartum year. This has significant implications for policy and service planning for women with mood disorders in the perinatal period.
KeywordsDepressive disorder Postpartum Data linkage
We would like to thank data custodians Lee Taylor, Kim Lim and Tony Dunn of the NSW Department of Health, Glenda Lawrence of the Centre for Health Record Linkage (CheReL) and John Lumby and Pia Salmelainen of the Pharmaceutical Services Branch of NSW Health for providing the data, undertaking the linkage and providing expert technical advice. The Perinatal & Women’s Mental Health Unit gratefully acknowledges infrastructure funding of St John of God Health Care. We acknowledge the families who have contributed their data to this study. Funding for this study was provided by Australian National Health and Medical Research Council (NHMRC) Training Fellowship.
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