Abstract
Background
Maternal mental health as an important precursor to reproductive and neonatal complications
remains understudied in the United States, particularly in the Southeastern region,
despite high medical costs, maternal morbidity, and infant burden. This study sought
to estimate the incidence of perinatal mental health disorders and the associated
increased risk of leading pregnancy and infant complications.
Methods
A population-based retrospective birth cohort of childbirth hospitalizations and readmissions
was constructed for women in South Carolina, 1999 to 2017. Prevalence rates were calculated
for perinatal mood and anxiety disorders (PMAD), severe mental illness, and mental
disorders of pregnancy (MDP). Poisson regression models using generalized estimating
equations were used to estimate adjusted relative risks for the association between
mental health conditions and severe maternal morbidity, hypertensive disorders of
pregnancy, gestational diabetes, cesarean section, preterm birth, and low birthweight.
Results
The most prevalent maternal mental condition was MDP (3.9%), followed by PMAD (2.7%)
and severe mental illness (0.13%). PMAD was associated with a higher risk of severe
maternal morbidity, hypertensive disorders of pregnancy, and cesarean section, as
well as a higher risk of preterm birth and low birthweight infants. Severe mental
illness was associated with low birthweight, hypertensive disorders of pregnancy,
and cesarean section. Pregnant populations with MDP were more at risk for severe maternal
morbidity, preterm birth, hypertensive disorders of pregnancy, low birthweight, and
cesarean section. Each maternal mental health outcome was associated with an increased
risk for hospital readmissions up to 45 days after childbirth.
Conclusions
Results demonstrate the escalating burden of PMAD and MDP for pregnant populations
over time, with important consequences related to maternal and infant morbidity.
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Biography
Jennifer D. Runkle, PhD, MSPH, is at the North Carolina Institute for Climate Studies, North Carolina State University. Her research interests include maternal and child health, environmental epidemiology, and social determinants of health.
Biography
Kendra Risley, is at the North Carolina Institute for Climate Studies, North Carolina State University. Her research interests include social epidemiology and maternal and child health.
Biography
Manan Roy, is at the Department of Nutrition and Health Care Management, Appalachian State University, Boone, North Carolina. Her research interests include health policy and health care utilization.
Biography
Maggie M. Sugg, is at the Department of Geography and Planning, Appalachian State University. Her research interests include medical geography and spatial determinants of health.
Article info
Publication history
Published online: January 06, 2023
Accepted:
December 9,
2022
Received in revised form:
November 30,
2022
Received:
May 27,
2022
Publication stage
In Press Corrected ProofFootnotes
Funding Statement: Research reported in this publication was supported by National Institute of Environmental Health Sciences of the National Institutes of Health under award number [1R03ES031228-01A1].
Data Statement: Data for this project are unsuitable to post publicly owing to a data use agreement with the state of South Carolina's Revenue and Fiscal Affairs Office Health and Demographics division.
Identification
Copyright
© 2022 Jacobs Institute of Women's Health, George Washington University. Published by Elsevier Inc. All rights reserved.
