Trends in and obstacles associated with mental health condition diagnoses during delivery hospitalizations

Mental health conditions during delivery hospitalizations are not well described. A recent study characterized the prevalence of maternal mental health condition diagnoses and associated risk during delivery hospitalizations.

Delivery hospitalizations of women (aged 15 to 54 years) with and without mental health condition diagnoses (like depressive disorder, anxiety disorder, bipolar spectrum disorder, and schizophrenia spectrum disorder) were identified. Temporal trends in mental health condition diagnoses during delivery hospitalizations were evaluated. The trends in chronic conditions associated with mental health condition diagnoses (like asthma, pregestational diabetes mellitus, chronic hypertension, obesity, and substance use) were also analyzed. The association of mental health conditions with the following adverse outcomes was determined: (1) severe maternal morbidity, (2) preeclampsia or gestational hypertension, (3) preterm delivery, (4) postpartum hemorrhage, (5) cesarean delivery, (6) maternal mortality. 

The results were described as follows-

• Among 73,109,791 delivery hospitalizations, 3.2% had ≥1 associated mental health condition diagnosis. 
• The proportion of delivery hospitalizations with a mental health condition augmented from 0.6% to 7.3% in 2000 to 2018 respectively. 
• Among deliveries in women with a mental health condition diagnosis, chronic health conditions, including asthma, pregestational diabetes mellitus, chronic hypertension, obesity, and substance use, rose from 14.9% to 38.5% in 2000 to 2018 respectively. 
• Deliveries to women with a mental health condition diagnosis were found to be associated with severe maternal morbidity, preeclampsia and gestational hypertension, preterm delivery, postpartum hemorrhage, cesarean delivery, and maternal death. 
• The increased risk was maintained in adjusted models.

The proportion of delivery hospitalizations with mental health condition diagnoses increased markedly throughout the study period. Mental health condition diagnoses were found to be associated with other underlying chronic health conditions and a fairly increased risk of many adverse outcomes. These findings suggest that mental health conditions are an important risk factor in adverse maternal outcomes.

SOURCE- Am J Obstet Gynecol. 2022 Mar;226(3):405.e1-405.e16.