ResearchObstetricsPerinatal outcomes among women with bipolar disorder: a population-based cohort study
Section snippets
Data sources
We used population-level health administrative data housed at the Institute for Clinical and Evaluative Sciences (ICES) in the Province of Ontario, Canada. ICES is an independent nonprofit research organization that has the capacity to link multiple provincial administrative health databases using unique identifiers for every Ontario resident with a provincial health card number. At ICES, patient-level records are linked anonymously via the Registered Persons Database (RPDB) that contains the
Results
Women with both bipolar disorder and major depressive disorder were more likely to be an adolescent than a woman without a history of mental illness, were more likely to be in the lowest income quintile, to have prepregnancy diabetes mellitus, and to have chronic hypertension (Table 1). Groups did not differ with regard to the timing or frequency of prenatal care. Twenty percent (n = 391) of women with bipolar disorder and 15% (n = 557) of women with depression had been hospitalized for mental
Comment
The newborns of women previously hospitalized for bipolar disorder were at up to 2 times higher risk for adverse perinatal outcomes, including prematurity and severe LGA birthweight. Other maternal characteristics could not fully explain this higher risk. Infants of women with major depressive disorder also had a similarly higher risk of adverse outcomes, but were more likely to be severely SGA rather than LGA.
Key strengths of this study include: (1) a large sample (n = 1859 women with bipolar
Acknowledgments
Alice Newman carried out the dataset creation and statistical analysis. Ms Newman is employed as an analyst at the Institute for Clinical Evaluative Sciences in Toronto, Ontario. Her time was funded through the operating grant that supported this study (Schizophrenia Society of Ontario). Ms Newman has consented to this acknowledgement.
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Cited by (0)
The authors report no conflict of interest. All authors declare that no authors (nor their institutions) received payments for their efforts on this project. Within the last 3 years, S.N.V. received a one-time honorarium from MDH consulting for the development of continuing education materials related to perinatal mental health. The remaining authors report no financial disclosures.
The operating costs of this project were funded by a peer-reviewed grant from the Schizophrenia Society of Ontario (Helen Pfohl Fund). In addition, this study was supported by the Institute for Clinical Evaluative Sciences (ICES), which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC).
No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred.
Cite this article as: Mei-Dan E, Ray JG, Vigod SN. Perinatal outcomes among women with bipolar disorder: a population-based cohort study. Am J Obstet Gynecol 2015;212:367.e1-8.