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Obstetric near misses among women with serious mental illness: data linkage cohort study
BACKGROUND: Investigating obstetric near misses (life-threatening obstetric complications) provides crucial information to prevent maternal mortality and morbidity. AIMS: To investigate the rate and type of obstetric near misses among women with serious mental illness (SMI). METHOD: We conducted a h...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cambridge University Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8387856/ https://www.ncbi.nlm.nih.gov/pubmed/33427147 http://dx.doi.org/10.1192/bjp.2020.250 |
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author | Easter, Abigail Sandall, Jane Howard, Louise M. |
author_facet | Easter, Abigail Sandall, Jane Howard, Louise M. |
author_sort | Easter, Abigail |
collection | PubMed |
description | BACKGROUND: Investigating obstetric near misses (life-threatening obstetric complications) provides crucial information to prevent maternal mortality and morbidity. AIMS: To investigate the rate and type of obstetric near misses among women with serious mental illness (SMI). METHOD: We conducted a historical cohort study, using de-identified electronic mental health records linked with maternity data from Hospital Episode Statistics. The English Maternal Morbidity Outcome Indicator was used to identify obstetric near misses at the time of delivery in two cohorts: (1) exposed cohort – all women with a live or still birth in 2007–2016, and a history of secondary mental healthcare before delivery in south-east London (n = 13 570); (2) unexposed cohort – all women with a live or still birth in 2007–2016, resident within south-east London, with no history of mental healthcare before delivery (n = 223 274). RESULTS: The rate of obstetric near misses was 884.3/100 000 (95% CI 733.2–1057.4) maternities in the exposed group compared with 575.1/100 000 (95% CI 544.0–607.4) maternities in the unexposed group (adjusted odds ratio 1.6, 95% CI 1.3–2.0, P < 0.001). Highest risks were for acute renal failure (adjusted odds ratio 2.1, 95% CI 1.1–3.8, P = 0.022); cardiac arrest, failure or infarction (adjusted odds ratio 2.3, 95% CI 1.1–4.8, P = 0.028); and obstetric embolism (adjusted odds ratio 3.1, 95% CI 1.6–5.8, P < 0.001). CONCLUSIONS: Findings emphasise the importance of integrated physical and mental healthcare before and during pregnancy for women with SMI. |
format | Online Article Text |
id | pubmed-8387856 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Cambridge University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-83878562021-09-01 Obstetric near misses among women with serious mental illness: data linkage cohort study Easter, Abigail Sandall, Jane Howard, Louise M. Br J Psychiatry Paper BACKGROUND: Investigating obstetric near misses (life-threatening obstetric complications) provides crucial information to prevent maternal mortality and morbidity. AIMS: To investigate the rate and type of obstetric near misses among women with serious mental illness (SMI). METHOD: We conducted a historical cohort study, using de-identified electronic mental health records linked with maternity data from Hospital Episode Statistics. The English Maternal Morbidity Outcome Indicator was used to identify obstetric near misses at the time of delivery in two cohorts: (1) exposed cohort – all women with a live or still birth in 2007–2016, and a history of secondary mental healthcare before delivery in south-east London (n = 13 570); (2) unexposed cohort – all women with a live or still birth in 2007–2016, resident within south-east London, with no history of mental healthcare before delivery (n = 223 274). RESULTS: The rate of obstetric near misses was 884.3/100 000 (95% CI 733.2–1057.4) maternities in the exposed group compared with 575.1/100 000 (95% CI 544.0–607.4) maternities in the unexposed group (adjusted odds ratio 1.6, 95% CI 1.3–2.0, P < 0.001). Highest risks were for acute renal failure (adjusted odds ratio 2.1, 95% CI 1.1–3.8, P = 0.022); cardiac arrest, failure or infarction (adjusted odds ratio 2.3, 95% CI 1.1–4.8, P = 0.028); and obstetric embolism (adjusted odds ratio 3.1, 95% CI 1.6–5.8, P < 0.001). CONCLUSIONS: Findings emphasise the importance of integrated physical and mental healthcare before and during pregnancy for women with SMI. Cambridge University Press 2021-09 /pmc/articles/PMC8387856/ /pubmed/33427147 http://dx.doi.org/10.1192/bjp.2020.250 Text en © The Authors 2021 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Paper Easter, Abigail Sandall, Jane Howard, Louise M. Obstetric near misses among women with serious mental illness: data linkage cohort study |
title | Obstetric near misses among women with serious mental illness: data linkage cohort study |
title_full | Obstetric near misses among women with serious mental illness: data linkage cohort study |
title_fullStr | Obstetric near misses among women with serious mental illness: data linkage cohort study |
title_full_unstemmed | Obstetric near misses among women with serious mental illness: data linkage cohort study |
title_short | Obstetric near misses among women with serious mental illness: data linkage cohort study |
title_sort | obstetric near misses among women with serious mental illness: data linkage cohort study |
topic | Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8387856/ https://www.ncbi.nlm.nih.gov/pubmed/33427147 http://dx.doi.org/10.1192/bjp.2020.250 |
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