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Am J Perinatol 2021; 38(02): 115-121
DOI: 10.1055/s-0039-1694759
Original Article

Postpartum Psychiatric Admissions in the United States

Timothy Wen
1   Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York
,
Arielle W. Fein
2   Vagelos College of Physicians and Surgeons, Columbia University, New York
,
Jason D. Wright
1   Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York
,
William J. Mack
3   Department of Neurological Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California
,
Frank J. Attenello
3   Department of Neurological Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California
,
Mary E. D'Alton
1   Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York
,
Alexander M. Friedman
1   Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York
› Author Affiliations Funding A.M.F. is supported by a career development award (K08HD082287) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health.
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Abstract

Objective This study aimed to assess risk for postpartum psychiatric admissions in the United States.

Study Design This study used the 2010 to 2014 Nationwide Readmissions Database to identify psychiatric admissions during the first 60 days after delivery hospitalization. Timing of admission after delivery discharge was determined. We fit multivariable log-linear regression models to assess the impact of psychiatric comorbidity on admission risk, adjusting for patient, obstetrical, and hospital factors.

Results Of 15.7 million deliveries from 2010 to 2014, 11,497 women (0.07%) were readmitted for a primary psychiatric diagnosis within 60 days postpartum. Psychiatric admissions occurred relatively consistently across 10-day periods after delivery hospitalization discharge. Psychiatric diagnoses were present among 5% of women at delivery but 40% of women who were readmitted postpartum for a psychiatric indication. In the adjusted model, women with psychiatric diagnoses at delivery hospitalization were 9.7 times more likely to be readmitted compared with those without psychiatric comorbidity. Women at highest risk for psychiatric admission were those with Medicare and Medicaid, in lower income quartiles, and of younger age.

Conclusion While a large proportion of psychiatric admissions occurred among a relatively small proportion of at-risk women, admissions occurred over a broad temporal period relative to other indications for postpartum admission.

Keywords

postpartum depression - psychiatric readmissions - obstetric conditions - maternal risk

Note

This study was presented at the 2019 Annual Meeting of the Society for Maternal-Fetal Medicine.




Publication History

Received: 08 April 2019

Accepted: 05 July 2019

Article published online:
14 August 2019

© 2019. Thieme. All rights reserved.

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