Short stay vs long stay postpartum psychiatric admissions: a population-based study

Arch Womens Ment Health. 2017 Aug;20(4):505-513. doi: 10.1007/s00737-017-0733-x. Epub 2017 May 26.

Abstract

About 1-2/1000 of postpartum women require psychiatric admission. Length of stay is variable, and little is known about short postpartum admission. From all women in Ontario, Canada, with a psychiatric admission within 1 year postpartum (2007-2012) (n = 1702), we compared women with admissions <72 h to women with longer admissions on sociodemographics, clinical characteristics and post-discharge mental health service use. About 37% of admissions were <72 h. These women were more likely to be adolescents (11.7 vs 7.3%), less likely to be employed (16.6 vs 25.9%) compared to women with longer admissions, and fewer had a prior history of psychiatric admission (16.7 vs 59.0%). Index diagnoses of alcohol or substance use (12.5 vs 7.8%) and adjustment disorders (15.8 vs 6.3%) were more common in the short vs longer stay group; psychotic (5.8 vs 19.5%) and bipolar disorders (2.1 vs 14.2%) were less common. Women with short admission were at higher crude risk for ED revisit 7 days post-discharge (11.4 vs 4.9% OR2.52, 95% CI1.74-3.66) and at lower adjusted risk for readmission at 365 days post-discharge (19.5 vs 28.8%, aOR 0.63, 95% CI 0.46-0.85). Women with short stay postpartum admissions are a clinically distinct group that may benefit from targeted intervention.

Keywords: Length of stay; Outcome; Postpartum psychiatric admission; Readmission.

MeSH terms

  • Adult
  • Canada
  • Cohort Studies
  • Female
  • Hospitalization
  • Humans
  • Length of Stay / statistics & numerical data*
  • Maternal Age
  • Mental Disorders / diagnosis
  • Mental Disorders / epidemiology*
  • Mental Disorders / psychology
  • Mental Health Services / statistics & numerical data*
  • Ontario / epidemiology
  • Patient Admission / statistics & numerical data*
  • Population Surveillance
  • Postpartum Period / psychology*
  • Residence Characteristics
  • Young Adult

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