Positive screening rates for bipolar disorder in pregnant and postpartum women and associated risk factors

Gen Hosp Psychiatry. 2019 Nov-Dec:61:53-59. doi: 10.1016/j.genhosppsych.2019.09.002. Epub 2019 Oct 22.


Objective: Bipolar disorder affects 2-8% of pregnant and postpartum women; untreated illness is associated with poor outcomes. This study aimed to describe bipolar disorder screening rates in obstetric settings and associated characteristics.

Method: Women were recruited during pregnancy through three months postpartum from 14 obstetric clinics in Massachusetts. The Mood Disorder Questionnaire (MDQ) was used to screen for bipolar disorder; a subset previously diagnosed with bipolar was also examined. Differences in characteristics by screening outcome were tested using chi-square and t-tests.

Results: Of 574 participating women, 18.8% screened positive for bipolar disorder. Compared to those with negative, those with positive bipolar screens had 18.5-times the prevalence of positive substance use screens (11.1% vs. 0.6%, p < 0.001) and 3.4-times reported feeling they were not receiving adequate psychiatric help (24.0 vs. 7.0%, p < 0.001). Less than half of those with positive bipolar screens (42.0%) and 61.3% with pre-existing bipolar reported receiving current psychiatric care.

Conclusions: Almost one in five perinatal women screened positive for bipolar disorder. Positive screenings were associated with comorbid substance use and low treatment rates. This study highlights the importance of screening for bipolar disorder during the perinatal period and the need for systematic approaches to ensure adequate assessment and follow-up.

Clinical trials registration: ClinicalTrials.gov identifier: NCT02760004.

Keywords: Bipolar disorder; Mood Disorder Questionnaire; Perinatal.

Publication types

  • Clinical Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Bipolar Disorder / diagnosis*
  • Bipolar Disorder / epidemiology
  • Female
  • Hospitals, Maternity / statistics & numerical data
  • Humans
  • Longitudinal Studies
  • Massachusetts / epidemiology
  • Middle Aged
  • Pregnancy
  • Pregnancy Complications / diagnosis*
  • Pregnancy Complications / epidemiology
  • Puerperal Disorders / diagnosis
  • Puerperal Disorders / epidemiology
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT02760004