Department of Economics and Business Economics

Benedicte Marie Winther Johannsen

Pre-eclampsia and first-onset postpartum psychiatric episodes: a Danish population-based cohort study

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Pre-eclampsia and first-onset postpartum psychiatric episodes : a Danish population-based cohort study. / Bergink, V; Laursen, T M; Johannsen, B M W; Kushner, S A; Meltzer-Brody, S; Munk-Olsen, T.

In: Psychological Medicine, Vol. 45, No. 16, 12.2015, p. 3481-3489.

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Bergink, V ; Laursen, T M ; Johannsen, B M W ; Kushner, S A ; Meltzer-Brody, S ; Munk-Olsen, T. / Pre-eclampsia and first-onset postpartum psychiatric episodes : a Danish population-based cohort study. In: Psychological Medicine. 2015 ; Vol. 45, No. 16. pp. 3481-3489.

Bibtex

@article{a2d5b72535ac42c98aa22ce35ac77552,
title = "Pre-eclampsia and first-onset postpartum psychiatric episodes: a Danish population-based cohort study",
abstract = "BACKGROUND: Recent evidence suggests that postpartum psychiatric episodes may share similar etiological mechanisms with immune-related disorders. Pre-eclampsia is one of the most prevalent immune-related disorders of pregnancy. Multiple clinical features are shared between pre-eclampsia and postpartum psychiatric disorders, most prominently a strong link to first pregnancies. Therefore, we aimed to study if pre-eclampsia is a risk factor for first-onset postpartum psychiatric episodes.METHOD: We conducted a cohort study using the Danish population registry, with a total of 400 717 primiparous women with a singleton delivery between 1995 and 2011. First-lifetime childbirth was the main exposure variable and the outcome of interest was first-onset postpartum psychiatric episodes. The main outcome measures were monthly incidence rate ratios (IRRs), with the period 11-12 months after birth as the reference category. Adjustments were made for age, calendar period, reproductive history, and perinatal maternal health including somatic and obstetric co-morbidity.RESULTS: Primiparous women were at particularly high risk of first-onset psychiatric episodes during the first month postpartum [IRR 2.93, 95{\%} confidence interval (CI) 2.53-3.40] and pre-eclampsia added to that risk (IRR 4.21, 95{\%} CI 2.89-6.13). Having both pre-eclampsia and a somatic co-morbidity resulted in the highest risk of psychiatric episodes during the 3-month period after childbirth (IRR 4.81, 95{\%} CI 2.72-8.50).CONCLUSIONS: We confirmed an association between pre-eclampsia and postpartum psychiatric episodes. The possible explanations for this association, which are not mutually exclusive, include the psychological impact of a serious medical condition such as pre-eclampsia and the neurobiological impact of pre-eclampsia-related vascular pathology and inflammation.",
author = "V Bergink and Laursen, {T M} and Johannsen, {B M W} and Kushner, {S A} and S Meltzer-Brody and T Munk-Olsen",
year = "2015",
month = "12",
doi = "10.1017/S0033291715001385",
language = "English",
volume = "45",
pages = "3481--3489",
journal = "Psychological Medicine",
issn = "0033-2917",
publisher = "Cambridge University Press",
number = "16",

}

RIS

TY - JOUR

T1 - Pre-eclampsia and first-onset postpartum psychiatric episodes

T2 - a Danish population-based cohort study

AU - Bergink, V

AU - Laursen, T M

AU - Johannsen, B M W

AU - Kushner, S A

AU - Meltzer-Brody, S

AU - Munk-Olsen, T

PY - 2015/12

Y1 - 2015/12

N2 - BACKGROUND: Recent evidence suggests that postpartum psychiatric episodes may share similar etiological mechanisms with immune-related disorders. Pre-eclampsia is one of the most prevalent immune-related disorders of pregnancy. Multiple clinical features are shared between pre-eclampsia and postpartum psychiatric disorders, most prominently a strong link to first pregnancies. Therefore, we aimed to study if pre-eclampsia is a risk factor for first-onset postpartum psychiatric episodes.METHOD: We conducted a cohort study using the Danish population registry, with a total of 400 717 primiparous women with a singleton delivery between 1995 and 2011. First-lifetime childbirth was the main exposure variable and the outcome of interest was first-onset postpartum psychiatric episodes. The main outcome measures were monthly incidence rate ratios (IRRs), with the period 11-12 months after birth as the reference category. Adjustments were made for age, calendar period, reproductive history, and perinatal maternal health including somatic and obstetric co-morbidity.RESULTS: Primiparous women were at particularly high risk of first-onset psychiatric episodes during the first month postpartum [IRR 2.93, 95% confidence interval (CI) 2.53-3.40] and pre-eclampsia added to that risk (IRR 4.21, 95% CI 2.89-6.13). Having both pre-eclampsia and a somatic co-morbidity resulted in the highest risk of psychiatric episodes during the 3-month period after childbirth (IRR 4.81, 95% CI 2.72-8.50).CONCLUSIONS: We confirmed an association between pre-eclampsia and postpartum psychiatric episodes. The possible explanations for this association, which are not mutually exclusive, include the psychological impact of a serious medical condition such as pre-eclampsia and the neurobiological impact of pre-eclampsia-related vascular pathology and inflammation.

AB - BACKGROUND: Recent evidence suggests that postpartum psychiatric episodes may share similar etiological mechanisms with immune-related disorders. Pre-eclampsia is one of the most prevalent immune-related disorders of pregnancy. Multiple clinical features are shared between pre-eclampsia and postpartum psychiatric disorders, most prominently a strong link to first pregnancies. Therefore, we aimed to study if pre-eclampsia is a risk factor for first-onset postpartum psychiatric episodes.METHOD: We conducted a cohort study using the Danish population registry, with a total of 400 717 primiparous women with a singleton delivery between 1995 and 2011. First-lifetime childbirth was the main exposure variable and the outcome of interest was first-onset postpartum psychiatric episodes. The main outcome measures were monthly incidence rate ratios (IRRs), with the period 11-12 months after birth as the reference category. Adjustments were made for age, calendar period, reproductive history, and perinatal maternal health including somatic and obstetric co-morbidity.RESULTS: Primiparous women were at particularly high risk of first-onset psychiatric episodes during the first month postpartum [IRR 2.93, 95% confidence interval (CI) 2.53-3.40] and pre-eclampsia added to that risk (IRR 4.21, 95% CI 2.89-6.13). Having both pre-eclampsia and a somatic co-morbidity resulted in the highest risk of psychiatric episodes during the 3-month period after childbirth (IRR 4.81, 95% CI 2.72-8.50).CONCLUSIONS: We confirmed an association between pre-eclampsia and postpartum psychiatric episodes. The possible explanations for this association, which are not mutually exclusive, include the psychological impact of a serious medical condition such as pre-eclampsia and the neurobiological impact of pre-eclampsia-related vascular pathology and inflammation.

U2 - 10.1017/S0033291715001385

DO - 10.1017/S0033291715001385

M3 - Journal article

C2 - 26243040

VL - 45

SP - 3481

EP - 3489

JO - Psychological Medicine

JF - Psychological Medicine

SN - 0033-2917

IS - 16

ER -