New perinatal mental health conditions diagnosed during COVID-19: a population-based, retrospective cohort study of birthing people in Ontario.

IF 3.2 3区医学 Q2 PSYCHIATRY Archives of Women's Mental Health Pub Date : 2024-11-19 DOI:10.1007/s00737-024-01534-1

Rebecca H Correia, Devon Greyson, David Kirkwood, Elizabeth K Darling, Manisha Pahwa, Hamideh Bayrampour, Aaron Jones, Cassandra Kuyvenhoven, Jessica Liauw, Meredith Vanstone

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Abstract

Purpose: We aimed to determine the incidence of mental health diagnoses and associated health and social risk factors among perinatal people in three different COVID-19 phases.

Methods: We conducted a population-based, retrospective cohort study using linked administrative datasets. We included persons with live, in-hospital births in Ontario, Canada from January 1 to March 31 in 2019, 2021, or 2022 (three phases relative to COVID-19 with different public health policy measures). We excluded people with prior mental health diagnoses. We used diagnostic codes to identify new onset of depression, anxiety, or adjustment disorder in the antenatal and postpartum period. We developed multivariable, modified Poisson models to examine associations between sociodemographic and clinical factors and new mental health diagnoses in each phase.

Results: There were 72,242 people in our cohort. Antenatal mental health diagnoses were significantly higher in 2021 (aRR = 1.32; CI = 1.20-1.46) and 2022 (aRR = 1.22; CI = 1.11-1.35) versus 2019. Postpartum diagnoses were significantly greater in 2021 (aRR = 1.16; CI = 1.08-1.25) versus 2019. Antenatal diagnoses were associated with birth year, previous stillbirth, pre-existing hypertension, multiparity, residential instability, and ethnocultural diversity. Postpartum diagnoses were associated with birth year, maternal age, multiparity, care provider profession, assisted reproductive technology, birthing mode, pre-existing hypertension, intensive care admission, hospital readmission, residential instability, and ethnocultural diversity. Family physicians increasingly made mental health diagnoses in 2021 and 2022.

Conclusion: Increased incidence of perinatal mental health diagnoses during COVID-19 suggests complex dynamics involving pandemic and health and social risk factors.

Registration: This study was registered with Clinicaltrials.gov (NCT05663762) on December 21, 2022.

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在 COVID-19 期间诊断出的新的围产期精神健康状况：对安大略省分娩人群进行的基于人口的回顾性队列研究。

目的：我们旨在确定 COVID-19 三个不同阶段围产期人群中精神健康诊断的发生率以及相关的健康和社会风险因素：我们使用关联的行政数据集开展了一项基于人群的回顾性队列研究。我们纳入了 2019 年、2021 年或 2022 年 1 月 1 日至 3 月 31 日在加拿大安大略省（与 COVID-19 相对的三个阶段，采取了不同的公共卫生政策措施）住院分娩的活产婴儿。我们排除了之前有精神健康诊断的人群。我们使用诊断代码来识别产前和产后新发的抑郁症、焦虑症或适应障碍。我们建立了多变量改良泊松模型来研究社会人口学和临床因素与各阶段新精神健康诊断之间的关联：结果：我们的队列中有 72 242 人。与 2019 年相比，2021 年（aRR = 1.32；CI = 1.20-1.46）和 2022 年（aRR = 1.22；CI = 1.11-1.35）的产前精神健康诊断率明显更高。与 2019 年相比，2021 年（aRR = 1.16；CI = 1.08-1.25）的产后诊断率明显更高。产前诊断与出生年份、死胎、原有高血压、多产妇、居住地不稳定和种族文化多样性有关。产后诊断与出生年份、产妇年龄、多胎性、护理提供者职业、辅助生殖技术、分娩方式、既往高血压、重症监护入院、再次入院、居住地不稳定和种族文化多样性有关。2021 年和 2022 年，越来越多的家庭医生做出了精神健康诊断：结论：在 COVID-19 期间，围产期精神健康诊断的发生率增加，表明涉及流行病、健康和社会风险因素的复杂动态：本研究于2022年12月21日在Clinicaltrials.gov（NCT05663762）注册。

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来源期刊

Archives of Women's Mental Health 医学-精神病学

CiteScore

8.00

自引率

4.40%

发文量

审稿时长

6-12 weeks

期刊介绍： Archives of Women’s Mental Health is the official journal of the International Association for Women''s Mental Health, Marcé Society and the North American Society for Psychosocial Obstetrics and Gynecology (NASPOG). The exchange of knowledge between psychiatrists and obstetrician-gynecologists is one of the major aims of the journal. Its international scope includes psychodynamics, social and biological aspects of all psychiatric and psychosomatic disorders in women. The editors especially welcome interdisciplinary studies, focussing on the interface between psychiatry, psychosomatics, obstetrics and gynecology. Archives of Women’s Mental Health publishes rigorously reviewed research papers, short communications, case reports, review articles, invited editorials, historical perspectives, book reviews, letters to the editor, as well as conference abstracts. Only contributions written in English will be accepted. The journal assists clinicians, teachers and researchers to incorporate knowledge of all aspects of women’s mental health into current and future clinical care and research.