Pregnancy alone does not appear to be associated with an increased risk of the most prevalent mental disorders, according to a new report. However, post-partum women may have a higher risk of major depressive disorder.
Pregnant women and those who have recently given birth are said to be exceedingly vulnerable to psychiatric disorders, according to background information in the article. Psychiatric disorders in these groups of women have been linked to poor maternal health, inadequate prenatal care and adverse outcomes for their children including abnormal growth and development, poor behavior during childhood and adolescence and negative nutritional and health effects. "For these reasons, accurate information about the mental health status of women during pregnancy and the post-partum period is urgently needed."
Oriana Vesga-López, M.D., of New York State Psychiatric Institute, New York, and colleagues analyzed data from interviews of 43,093 individuals who participated in a survey on alcohol, disorders and related conditions. Of these, 14,549 were women (age 18 to 50) who had been pregnant within the past year. Participants reported psychiatric disorders, substance use and whether they had sought treatment.
"Past-year pregnant and post-partum women had significantly lower rates of alcohol use disorders and any substance use, except illicit drug use, than non-pregnant women," the authors write. Also, women who were pregnant at the time of the study had a lower risk of having any mood disorder, except major depression, than non-pregnant women. "Age, marital status, health status, stressful life events and history of traumatic experiences were all significantly associated with higher risk of psychiatric disorders in pregnant and post-partum women."
Women who had been pregnant within the past year had lower treatment-seeking rates for any psychiatric disorder within the past year and within their lifetime. "Most women with a current psychiatric disorder did not receive any mental health care in the 12 months prior to the survey regardless of pregnancy status," the authors write.
Although pregnancy alone is not associated with an increased risk of the most common mental disorders, "groups of pregnant women with particularly high prevalence of psychiatric disorders were identified," the authors write. These groups included women age 18 to 25 living without a partner, widowed, separated, divorced or never married and women who experienced pregnancy complications or stressful life events. "Given the critical importance of this life period for mothers and their offspring, urgent action is needed to increase detection and treatment of psychiatric disorders among pregnant and post-partum women in the United States."
Dr. Blanco has received research support from Somaxon, Pfizer and GlaxoSmithKline. Dr. Olfson has received grants from Bristol-Myers Squibb, AstraZeneca and Eli Lilly and Co.; has worked as a consultant for Bristol-Myers Squibb, Eli Lilly and Co., Pfizer and McNeil; and serves on a speakers' bureau for Janssen. This study was supported by National Institutes of Health grants; a grant from the American Foundation for Suicide Prevention and the New York State Psychiatric Institute.
- Oriana Vesga-Lopez; Carlos Blanco; Katherine Keyes; Mark Olfson; Bridget F. Grant; Deborah S. Hasin. Psychiatric Disorders in Pregnant and Postpartum Women in the United States. Arch Gen Psychiatry, 2008;65(7):805-815 [link]
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