Factors associated with re-admission in the year after acute postpartum psychiatric treatment

TY - JOUR

T1 - Factors associated with re-admission in the year after acute postpartum psychiatric treatment

AU - Taylor, Billie Lever

AU - Sweeney, Angela

AU - Potts, Laura C

AU - Trevillion, Kylee

AU - Howard, Louise M

N1 - Funding Information: This paper summarises independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research (PGfAR) Programme (Grant Reference Number: RP-PG-1210–12002). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. This study was supported by the NIHR / Wellcome Trust King’s and Manchester Clinical Research Facility and the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. The study team acknowledges the support given by the national NIHR Clinical Research Networks. LMH is also supported by an NIHR Research Professorship (NIHR-RP-R3-12–011). AS, Development and Skills Enhancement fellow (NIHR300821), is also funded by the National Institute for Health Research (NIHR), and would like to acknowledge the support of the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. Funding Information: We gratefully acknowledge the advice received from our Patient and Public Advisory Group. We want to take the opportunity to acknowledge the support of the National Institute of Health Research Clinical Research Networks (NIHR CRN). We would also like to thank all the women who took part in this research study. Publisher Copyright: © 2022, The Author(s).

PY - 2022/10

Y1 - 2022/10

N2 - PURPOSE: To examine factors associated with being re-admitted in the year after discharge from acute postpartum psychiatric treatment.METHODS: Secondary data analysis of information collected from mothers who were admitted to acute psychiatric services in the year after childbirth between 2013 and 2017. We carried out univariable analyses and multivariable hierarchical logistic regression to examine risk factors for women's re-admission to acute psychiatric care (inpatient or community crisis care) in the year following discharge.RESULTS: Sixty-seven (24.1%) of 278 women were re-admitted in the year after discharge from acute care; the median number of days to re-admission was 86 (IQR 35-214), and women who were re-admitted accessed a median of two further acute services (IQR 1-3). In adjusted analyses, reporting a history of childhood trauma (aOR 1.02; 95% CI 1.00- 1.03, p = 0.036), a higher level of difficulties in the mother-infant bond (aOR 1.03; 95% CI 1.01-1.06, p = 0.009) and younger age (aOR 0.95; 95% CI 0.90-1.00, p = 0.066) were associated with re-admission.CONCLUSION: This study confirms that the role of childhood adverse experiences on mental health is relevant for outcomes in women experiencing acute postpartum psychiatric episodes. Ongoing parent-infant bonding difficulties are also independently associated with re-admission. Perinatal mental health services therefore need to offer evidence-based interventions to address histories of trauma and to support parent-infant bonding to optimise mental health in women following discharge from acute psychiatric services. However, further research is needed to explore what other factors, not measured in our study, are also influential to re-admission.

AB - PURPOSE: To examine factors associated with being re-admitted in the year after discharge from acute postpartum psychiatric treatment.METHODS: Secondary data analysis of information collected from mothers who were admitted to acute psychiatric services in the year after childbirth between 2013 and 2017. We carried out univariable analyses and multivariable hierarchical logistic regression to examine risk factors for women's re-admission to acute psychiatric care (inpatient or community crisis care) in the year following discharge.RESULTS: Sixty-seven (24.1%) of 278 women were re-admitted in the year after discharge from acute care; the median number of days to re-admission was 86 (IQR 35-214), and women who were re-admitted accessed a median of two further acute services (IQR 1-3). In adjusted analyses, reporting a history of childhood trauma (aOR 1.02; 95% CI 1.00- 1.03, p = 0.036), a higher level of difficulties in the mother-infant bond (aOR 1.03; 95% CI 1.01-1.06, p = 0.009) and younger age (aOR 0.95; 95% CI 0.90-1.00, p = 0.066) were associated with re-admission.CONCLUSION: This study confirms that the role of childhood adverse experiences on mental health is relevant for outcomes in women experiencing acute postpartum psychiatric episodes. Ongoing parent-infant bonding difficulties are also independently associated with re-admission. Perinatal mental health services therefore need to offer evidence-based interventions to address histories of trauma and to support parent-infant bonding to optimise mental health in women following discharge from acute psychiatric services. However, further research is needed to explore what other factors, not measured in our study, are also influential to re-admission.

UR - http://www.scopus.com/inward/record.url?scp=85137046633&partnerID=8YFLogxK

U2 - 10.1007/s00737-022-01255-3

DO - 10.1007/s00737-022-01255-3

M3 - Article

C2 - 36006457

SN - 1434-1816

VL - 25

SP - 975

EP - 983

JO - Archives of Women's Mental Health

JF - Archives of Women's Mental Health

IS - 5

ER -