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Am J Epidemiol. 2018 Sep 1;187(9):2060-2068. doi: 10.1093/aje/kwy080.

Chronic Medical Conditions and Peripartum Mental Illness: A Systematic Review and Meta-Analysis.

Author information

1
Interdisciplinary Centre for Health and Society, University of Toronto Scarborough, Toronto, Canada.
2
Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
3
Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada.
4
Women's College Research Institute, Women's College Hospital, Toronto, Canada.
5
Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.
6
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.

Abstract

The objective of this systematic review and meta-analysis was to examine the association between maternal chronic medical conditions (CMCs) and peripartum mental illness. MEDLINE, Embase, CINAHL, and PsycINFO were searched to September 2017. Data were extracted and quality was assessed using standardized instruments. We generated unadjusted and adjusted pooled odds ratios and 95% confidence intervals using DerSimonian and Laird random effects models. The review included 16 papers representing 12 studies and 1,626,260 women. CMCs overall were associated with peripartum mental illness overall (adjusted pooled odds ratios (aPOR) = 1.43, 95% confidence interval (CI): 1.25, 1.63). CMCs overall were associated with antepartum (aPOR = 1.41, 95% CI: 1.10, 1.81) and postpartum mental illness separately (aPOR = 1.44, 95% CI: 1.13, 1.85) and with peripartum depression (aPOR = 1.45, 95% CI: 1.25, 1.67) and anxiety separately (aPOR = 1.63, 95% CI: 1.35, 1.95). No studies examined bipolar or psychotic disorders. Diabetes (aPOR = 1.34, 95% CI: 1.07, 1.69), hypertension/heart disease (aPOR = 1.60, 95% CI: 1.05, 2.45), migraine (aPOR = 1.75, 95% CI: 1.20, 2.54), and other neurological disorders (aPOR = 1.45, 95% CI: 1.19, 1.77), but not asthma, were each associated with peripartum mental illness. Findings suggest that mental health resources should be integrated in medical settings where pregnant and postpartum women with CMCs are treated.

PMID:
29635285
DOI:
10.1093/aje/kwy080
[Indexed for MEDLINE]

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