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. 2010 Feb;45(1):246-64.
doi: 10.1111/j.1475-6773.2009.01058.x. Epub 2009 Oct 29.

Obstetric complications in women with diagnosed mental illness: the relative success of California's county mental health system

Dorothy Thornton  1 , Sylvia Guendelman, Nap Hosang
Affiliations

Obstetric complications in women with diagnosed mental illness: the relative success of California's county mental health system

Dorothy Thornton et al. Health Serv Res. 2010 Feb.

Abstract

Objective: To examine disparities in serious obstetric complications and quality of obstetric care during labor and delivery for women with and without mental illness.

Data source: Linked California hospital discharge (2000-2001), birth, fetal death, and county mental health system (CMHS) records.

Study design: This population-based, cross-sectional study of 915,568 deliveries in California, calculated adjusted odds ratios (AORs) for obstetric complication rates for women with a mental illness diagnosis (treated and not treated in the CMHS) compared with women with no mental illness diagnosis, controlling for sociodemographic, delivery hospital type, and clinical factors.

Results: Compared with deliveries in the general non-mentally ill population, deliveries to women with mental illness stand a higher adjusted risk of obstetric complication: AOR=1.32 (95 percent confidence interval [CI]=1.25, 1.39) for women treated in the CMHS and AOR=1.72 (95 percent CI=1.66, 1.79) for women not treated in the CMHS. Mentally ill women treated in the CMHS are at lower risk than non-CMHS mentally ill women of experiencing conditions associated with suboptimal intrapartum care (postpartum hemorrhage, major puerperal infections) and inadequate prenatal care (acute pyelonephritis).

Conclusion: Since mental disorders during pregnancy adversely affect mothers and their infants, care of the mentally ill pregnant woman by mental health and primary care providers warrants special attention.

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