First lifetime psychiatric admission in the postpartum period: a population-based comparison to women with prior psychiatric admission

Objectives — To better understand women with a first lifetime psychiatric hospitalization in the postpartum period.

Methods — We included all 1071 postpartum women in Ontario, Canada with a psychiatric admission in the 1-year postpartum (2007–2012). We compared women with their first lifetime psychiatric admission to those with any prior psychiatric admission on demographic and clinical characteristics, and on mental health physician visits, psychiatric emergency department (ED) re-visits and psychiatric readmission within 1 year post-discharge.

Results — Compared to women with prior admission, women with a first lifetime admission (n=537, 59%) were less likely to have psychotic disorders (14% vs. 25%) and had shorter lengths of stay (13.6 +/−12.7 vs. 18.9 +/− 27.8 days). Women with prior admission were at higher risk for ED re-visits (44% vs. 32%, OR 1.63, 95% CI 1.26-2.09) and readmissions (32% vs. 24%, OR 1.82, 95% CI 1.39-2.38) by 1 year post-discharge versus women with first lifetime admission; differences were explained by clinical factors.

Conclusions — Although women with a first lifetime psychiatric admission postpartum have a favourable clinical course up to 1 year after index admission versus women with any prior admission, 25% are readmitted with 1 year post-discharge, underscoring need for attention to this group.