Prevalence and incidence of moderate and severe mental illness in the second postpartum year in England (1995–2020): a national retrospective cohort study using primary care dataResearch in context
Summary: Background: Perinatal mental illness affects around 20% of women in pregnancy and the first postpartum year with little evidence regarding persistence and incidence in the second year. This study aimed to describe prevalence and incidence of moderate and severe mental illness in the second...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-06-01
|
| Series: | The Lancet Regional Health. Europe |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666776225001048 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850279366311804928 |
|---|---|
| author | Ellie Jones Laura Quinn Jamie-Rae Tanner Jelena Jankovic Giles Berrisford Christine MacArthur Beck Taylor |
| author_facet | Ellie Jones Laura Quinn Jamie-Rae Tanner Jelena Jankovic Giles Berrisford Christine MacArthur Beck Taylor |
| author_sort | Ellie Jones |
| collection | DOAJ |
| description | Summary: Background: Perinatal mental illness affects around 20% of women in pregnancy and the first postpartum year with little evidence regarding persistence and incidence in the second year. This study aimed to describe prevalence and incidence of moderate and severe mental illness in the second postpartum year to estimate the proportion of women who could benefit from extension of England's specialist perinatal mental health services to two years. Methods: A retrospective cohort study using United Kingdom primary care Clinical Practice Research Datalink GOLD. All women registered with a General Practitioner with third trimester, delivery code or postpartum medical record 1995–2020 were included. Secondary objectives were to investigate mental illness type and associated factors. Findings: 2,132,754 pregnancies from 1,361,497 women were included. Prevalence of mental illness likely to need specialist PMH services in second postpartum year increased significantly from 3.1% (n = 2643/85,756) in 1995 to 7.4% (n = 2473/34,098) in 2018. Incident cases increased from 1.9% (n = 1630/85,756) in 1995 to 3.8% (n = 1285/34,098) in 2018 representing 56.6% (n = 69,926/123,510) of all cases in the second year. Adjusted analysis showed odds of mental illness in second year were higher: for women in most ages vs 30–34 yrs; for each additional pregnancy (OR: 1.16, 95% CI: 1.13, 1.19 two vs one); for preterm births (OR: 1.21, 95% CI: 1.15, 1.27), near term (OR: 1.21, 95% CI: 1.17, 1.25) or post-term (OR: 1.07, 95% CI: 1.04, 1.09) vs term; with history of mental illness (OR: 2.46, 95% CI: 2.41, 2.52), smoking (OR: 1.37, 95% CI: 1.35, 1.39), substance use disorder (OR: 1.54, 95% CI: 1.48, 1.60), and for each year vs 1995. Separate analysis using a subset of data showed odds of mental illness were higher for women in all quintiles vs least deprived and for women of white ethnicity vs all other ethnicities. Although severity could not be accurately measured, most recorded illnesses would require specialist perinatal mental health input. Interpretation: Extension of specialist perinatal mental health services to two years postpartum is justified. Funding: National Institute for Health and Care Research Applied Research Collaboration West Midlands (NIHR200165). |
| format | Article |
| id | doaj-art-11bd1de91cf449e98b23dcac08fee091 |
| institution | OA Journals |
| issn | 2666-7762 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Europe |
| spelling | doaj-art-11bd1de91cf449e98b23dcac08fee0912025-08-20T01:49:05ZengElsevierThe Lancet Regional Health. Europe2666-77622025-06-015310131210.1016/j.lanepe.2025.101312Prevalence and incidence of moderate and severe mental illness in the second postpartum year in England (1995–2020): a national retrospective cohort study using primary care dataResearch in contextEllie Jones0Laura Quinn1Jamie-Rae Tanner2Jelena Jankovic3Giles Berrisford4Christine MacArthur5Beck Taylor6Department of Applied Health Sciences, School of Applied Health Sciences, College of Medicine and Health, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom; Corresponding author. The Murray Learning Centre, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom.Department of Applied Health Sciences, School of Applied Health Sciences, College of Medicine and Health, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United KingdomWarwickshire County Council, Shire Hall, Market Place, Warwick, CV344RL, United KingdomBirmingham and Solihull Mental Health Foundation Trust, Perinatal Mental Health Service, The Barberry, 25 Vincent Drive, Birmingham, B15 3RB, United KingdomMaudsley Health, 201-205 Al Montazah Tower, Khalidiyah, Abu Dhabi, 41763, United Arab EmiratesDepartment of Applied Health Sciences, School of Applied Health Sciences, College of Medicine and Health, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United KingdomWarwick Medical School, University of Warwick, Coventry, CV4 7AL, United KingdomSummary: Background: Perinatal mental illness affects around 20% of women in pregnancy and the first postpartum year with little evidence regarding persistence and incidence in the second year. This study aimed to describe prevalence and incidence of moderate and severe mental illness in the second postpartum year to estimate the proportion of women who could benefit from extension of England's specialist perinatal mental health services to two years. Methods: A retrospective cohort study using United Kingdom primary care Clinical Practice Research Datalink GOLD. All women registered with a General Practitioner with third trimester, delivery code or postpartum medical record 1995–2020 were included. Secondary objectives were to investigate mental illness type and associated factors. Findings: 2,132,754 pregnancies from 1,361,497 women were included. Prevalence of mental illness likely to need specialist PMH services in second postpartum year increased significantly from 3.1% (n = 2643/85,756) in 1995 to 7.4% (n = 2473/34,098) in 2018. Incident cases increased from 1.9% (n = 1630/85,756) in 1995 to 3.8% (n = 1285/34,098) in 2018 representing 56.6% (n = 69,926/123,510) of all cases in the second year. Adjusted analysis showed odds of mental illness in second year were higher: for women in most ages vs 30–34 yrs; for each additional pregnancy (OR: 1.16, 95% CI: 1.13, 1.19 two vs one); for preterm births (OR: 1.21, 95% CI: 1.15, 1.27), near term (OR: 1.21, 95% CI: 1.17, 1.25) or post-term (OR: 1.07, 95% CI: 1.04, 1.09) vs term; with history of mental illness (OR: 2.46, 95% CI: 2.41, 2.52), smoking (OR: 1.37, 95% CI: 1.35, 1.39), substance use disorder (OR: 1.54, 95% CI: 1.48, 1.60), and for each year vs 1995. Separate analysis using a subset of data showed odds of mental illness were higher for women in all quintiles vs least deprived and for women of white ethnicity vs all other ethnicities. Although severity could not be accurately measured, most recorded illnesses would require specialist perinatal mental health input. Interpretation: Extension of specialist perinatal mental health services to two years postpartum is justified. Funding: National Institute for Health and Care Research Applied Research Collaboration West Midlands (NIHR200165).http://www.sciencedirect.com/science/article/pii/S2666776225001048Perinatal mental healthPerinatal mental illnessPsychiatry |
| spellingShingle | Ellie Jones Laura Quinn Jamie-Rae Tanner Jelena Jankovic Giles Berrisford Christine MacArthur Beck Taylor Prevalence and incidence of moderate and severe mental illness in the second postpartum year in England (1995–2020): a national retrospective cohort study using primary care dataResearch in context The Lancet Regional Health. Europe Perinatal mental health Perinatal mental illness Psychiatry |
| title | Prevalence and incidence of moderate and severe mental illness in the second postpartum year in England (1995–2020): a national retrospective cohort study using primary care dataResearch in context |
| title_full | Prevalence and incidence of moderate and severe mental illness in the second postpartum year in England (1995–2020): a national retrospective cohort study using primary care dataResearch in context |
| title_fullStr | Prevalence and incidence of moderate and severe mental illness in the second postpartum year in England (1995–2020): a national retrospective cohort study using primary care dataResearch in context |
| title_full_unstemmed | Prevalence and incidence of moderate and severe mental illness in the second postpartum year in England (1995–2020): a national retrospective cohort study using primary care dataResearch in context |
| title_short | Prevalence and incidence of moderate and severe mental illness in the second postpartum year in England (1995–2020): a national retrospective cohort study using primary care dataResearch in context |
| title_sort | prevalence and incidence of moderate and severe mental illness in the second postpartum year in england 1995 2020 a national retrospective cohort study using primary care dataresearch in context |
| topic | Perinatal mental health Perinatal mental illness Psychiatry |
| url | http://www.sciencedirect.com/science/article/pii/S2666776225001048 |
| work_keys_str_mv | AT elliejones prevalenceandincidenceofmoderateandseverementalillnessinthesecondpostpartumyearinengland19952020anationalretrospectivecohortstudyusingprimarycaredataresearchincontext AT lauraquinn prevalenceandincidenceofmoderateandseverementalillnessinthesecondpostpartumyearinengland19952020anationalretrospectivecohortstudyusingprimarycaredataresearchincontext AT jamieraetanner prevalenceandincidenceofmoderateandseverementalillnessinthesecondpostpartumyearinengland19952020anationalretrospectivecohortstudyusingprimarycaredataresearchincontext AT jelenajankovic prevalenceandincidenceofmoderateandseverementalillnessinthesecondpostpartumyearinengland19952020anationalretrospectivecohortstudyusingprimarycaredataresearchincontext AT gilesberrisford prevalenceandincidenceofmoderateandseverementalillnessinthesecondpostpartumyearinengland19952020anationalretrospectivecohortstudyusingprimarycaredataresearchincontext AT christinemacarthur prevalenceandincidenceofmoderateandseverementalillnessinthesecondpostpartumyearinengland19952020anationalretrospectivecohortstudyusingprimarycaredataresearchincontext AT becktaylor prevalenceandincidenceofmoderateandseverementalillnessinthesecondpostpartumyearinengland19952020anationalretrospectivecohortstudyusingprimarycaredataresearchincontext |