The Correlation Between Perinatal Mental Illness And Physical Conditions

Throughout and after a pregnancy, a woman may experience different mental changes that may result into a serious mental disorder, such as depression or anxiety. The monitoring of a woman’s mental health during her pregnancy is known as perinatal mental health. The mental health illnesses that ensues during or after her pregnancy is called perinatal mental illness. Perinatal mental illness tends to be common in women in low- and middle-income countries, 25% of these women will experience prenatal depression and 19% will go through postpartum depression. There are different types of social causes for in which a woman may experience perinatal mental illness, such her race, ethnicity, social status, economic status, or a poor support system. Perinatal mental disorder may not only just affect the mother, but also the child, which can result in low birth weight, impaired infant growth, and problems between the relationship of the mother and child. For women to be properly diagnosed and treated for perinatal mental illness, researchers must continue to further study perinatal mental illness in order to identify risk factors to form appropriate and effective treatments.

Between 2005 and 2015, a study was done on a total of 858,004 women in Ontario, Canada, in which it was investigated the association of chronic physical conditions before conception and the probability of perinatal mental illness being diagnosed during pregnancy or a year afterwards. Studies on the association between perinatal mental disorder and chronic physical conditions have rarely been examined, which was one of the leading reasons as to why the analysis was done. The study was led by Hilary K. Brown, Cindy-Lee Dennis, Astrid Guttman, Joel G. Ray, Simon N. Vigod, and Andrew S. Wilton, and it compared women with chronic physical conditions to women without like conditions. The researchers found that of twelve studies done, all had shown an association between chronic physical conditions and perinatal mental illness, but none of the twelve studies were as thorough or as cautious with the subjects as the study done by Brown and her peers was.

The subjects were carefully selected following a criterion that included women between 15 to 49 years of age who had a live birth between April 1, 2005 – March 31, 2015 and excluded those whom had a diagnosed mental illness two years prior to the pregnancy. In total, 858,004 women in Ontario, Canada were selected in which 77,385 women had chronic physical conditions and were compared to 780,619 women who did not present the conditions. The participants were diagnosed during their pregnancy by more than one physician for any mental illness that may be presented during the pregnancy. The women were then followed for 365 days after birth to determine and verify the study’s hypothesis.

As Brown and her colleagues monitored the women during and after their pregnancies, they used the Agency for Healthcare Research and Quality Chronic Condition Indicator to capture the participants’ chronic physical conditions and health administrative data to compare the risks between the women being compared for perinatal mental illness. The researchers used different organizations to care for the participants as well as to have access, evaluate, and record health administrative data of the participants. Such organizations were the Institute of Clinical Evaluative Sciences (ICES), Ontario Mental Health Reporting System, Ontario Health Insurance Plan Database, and the Canadian Coding Standards for the Internation Statistical Classification of Diseases and Related Health Problems.

The study organized the chronic physical conditions by body system and defined chronic physical conditions as lasting 12 months or more and restricted the participant in their social life or required medical treatment. Different additional analyses were conducted to gain the best conclusions for the study. One analysis studied the relationship between the diagnosis of perinatal mental illness and chronic physical conditions and another analysis examined the correlation between of perinatal mental illness, chronic physical conditions, and body systems affected. The third analysis consisted of the participants going for at least two physician appointments for mental health reasons during or after pregnancy.

After the study and additional analyses were finalized, it was concluded that women with chronic physical conditions experienced perinatal mental illness than their counterparts. Of the 77,385 women with chronic physical conditions, 20% were found to have perinatal mental illness between conception and 365 after giving birth. About 16% of the women without chronic physical conditions were diagnosed with perinatal mental illness between conception and a year after giving birth. The additional analyses deduced that there is a higher risk for mental illness after pregnancy than during pregnancy, chronic physical conditions affecting more than one body system poses for higher risks for perinatal mental disease, and the third analyses established that women with chronic physical conditions would have an increase for perinatal mental illness.

I thought this was a well-done study due to the thorough analyzation between the correlation of perinatal mental illness and chronic physical conditions done by Brown and her coworkers. The reason for this being how particular the researchers were when deciding on participants and organizations to use to record and access medical records, which resulted in more accurate results. The study done by the researchers could now give more focus on physical conditions rather than social conditions when determining risk of perinatal mental illness. It helps females, like me, understand the risk for perinatal mental illness and people who may have/had it.

References

1. Brown HK, Wilton AS, Ray JG, Dennis CL, Guttmann A, Vigod SN (2019) Chronic physical conditions and risk for perinatal mental illness: A population-based retrospective cohort study. PLoS Med 16(8): e1002864. https://doi. org/10. 1371/ journal. pmed. 1002864
2. Health Care for Women International, Mcn, Journal of Women's Health, Health & Social Care, Reuters, New York Times, & BBC News. (2017, December 15). Perinatal Mental Health. Retrieved November 15, 2019, from https://www. mhtf. org/topics/perinatal-mental-health/.