General medical conditions and mortality in women with postpartum psychiatric disorders

TY - JOUR

T1 - General medical conditions and mortality in women with postpartum psychiatric disorders

AU - Johannsen, Benedicte Marie Winther

AU - Munk Laursen, Thomas

AU - Bech, Bodil Hammer

AU - Munk-Olsen, Trine

N1 - This article is protected by copyright. All rights reserved.

PY - 2020/12

Y1 - 2020/12

N2 - BACKGROUND: Psychiatric patients have an increased risk of general medical conditions and mortality, but no study has systematically explored these outcomes among women with mental disorders following childbirth (postpartum psychiatric disorders: PPD). Therefore, we aimed to investigate the risk of subsequent general medical conditions and mortality in women with a broad spectrum of PPD.METHODS: This register-based cohort study followed all Danish women born after Jan. 1st, 1960, until Jan. 1st, 2016. The exposure of interest was 1) mild-moderate PPD: first-ever prescription of psychotropic medication (ATC codes: N03-N07) and 2) severe PPD: first-ever in- or outpatient contact to a psychiatric facility, both within six months postpartum. Outcomes of interest were 1) hospital-registered chronic medical conditions and 2) mortality from natural and unnatural causes. We included 1,841,949 women representing 22,615,310 person-years at risk.RESULTS: Among 15,852 women with mild-moderate PPD and 4,266 women with severe PPD, we found a higher risk of any subsequent general medical condition (mild-moderate PPD: IRR 1.25; 95%CI 1.20-1.31 and severe PPD: IRR 1.35; 95%CI: 1.24-1.48) when compared to the female background population. Mortality from both natural and unnatural causes was higher in both groups: Mild-moderate PPD: natural causes MRR 1.37; 95%CI: 1.17-1.61; unnatural causes MRR 1.52; 95%CI: 1.10-2.11, severe PPD: natural causes MRR 1.42; 95%CI 1.02-2.00, and unnatural causes MRR 5.05; 95%CI: 3.40-7.51.CONCLUSIONS: This first overview of general medical prognosis in PPD shows that women at either end of the spectrum are at increased risk of subsequent chronic medical conditions and overall mortality.

AB - BACKGROUND: Psychiatric patients have an increased risk of general medical conditions and mortality, but no study has systematically explored these outcomes among women with mental disorders following childbirth (postpartum psychiatric disorders: PPD). Therefore, we aimed to investigate the risk of subsequent general medical conditions and mortality in women with a broad spectrum of PPD.METHODS: This register-based cohort study followed all Danish women born after Jan. 1st, 1960, until Jan. 1st, 2016. The exposure of interest was 1) mild-moderate PPD: first-ever prescription of psychotropic medication (ATC codes: N03-N07) and 2) severe PPD: first-ever in- or outpatient contact to a psychiatric facility, both within six months postpartum. Outcomes of interest were 1) hospital-registered chronic medical conditions and 2) mortality from natural and unnatural causes. We included 1,841,949 women representing 22,615,310 person-years at risk.RESULTS: Among 15,852 women with mild-moderate PPD and 4,266 women with severe PPD, we found a higher risk of any subsequent general medical condition (mild-moderate PPD: IRR 1.25; 95%CI 1.20-1.31 and severe PPD: IRR 1.35; 95%CI: 1.24-1.48) when compared to the female background population. Mortality from both natural and unnatural causes was higher in both groups: Mild-moderate PPD: natural causes MRR 1.37; 95%CI: 1.17-1.61; unnatural causes MRR 1.52; 95%CI: 1.10-2.11, severe PPD: natural causes MRR 1.42; 95%CI 1.02-2.00, and unnatural causes MRR 5.05; 95%CI: 3.40-7.51.CONCLUSIONS: This first overview of general medical prognosis in PPD shows that women at either end of the spectrum are at increased risk of subsequent chronic medical conditions and overall mortality.

KW - epidemiology

KW - mortality

KW - physical illness

KW - post partum

UR - http://www.scopus.com/inward/record.url?scp=85091457011&partnerID=8YFLogxK

U2 - 10.1111/acps.13232

DO - 10.1111/acps.13232

M3 - Journal article

C2 - 32918276

SN - 0001-690X

VL - 142

SP - 467

EP - 475

JO - Acta Psychiatrica Scandinavica

JF - Acta Psychiatrica Scandinavica

IS - 6

ER -