Obstetric variables associated with bipolar affective puerperal psychosis

Br J Psychiatry. 2006 Jan;188:32-6. doi: 10.1192/bjp.188.1.32.


Background: Previous cross-sectional studies have highlighted a number of obstetric variables that may be associated with the development of broadly defined puerperal (post-partum) psychosis. These include: (a) primiparity, (b) pregnancy complications, (c) delivery complications, (d) Caesarean section, (e) female baby and (f) shorter gestation period.

Aims: To examine these risk factors in women with well-characterised bipolar affective puerperal psychosis.

Method: A sample of 129 women with bipolar affective puerperal psychosis were investigated using a design that takes advantage of within-subject comparisons of affected and unaffected deliveries.

Results: Two of the variables studied were independently associated with an episode of puerperal psychosis: primiparity (odds ratio=3.76, P < 0.001) and delivery complications (odds ratio=2.68, P=0.022).

Conclusions: This study provides further evidence of the association between primiparity and puerperal psychosis and suggests that complications during delivery may be associated with a severe post-partum episode.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bipolar Disorder / etiology*
  • Cross-Sectional Studies
  • Depression, Postpartum / etiology*
  • Female
  • Humans
  • Logistic Models
  • Middle Aged
  • Obstetric Labor Complications / psychology*
  • Parity
  • Pregnancy
  • Risk Factors
  • United Kingdom