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Hospital Outcomes in Antepartum Mental Disorders: A Study on 897,397 Pregnant Inpatients

1
Department of Public Administration, Drake University, Des Moines, IA 50311, USA
2
Department of Psychiatry, Washington DC VA Medical Center, Washington, DC 20422, USA
3
Department of Gynecology, Rao Hospital, Coimbatore 641002, India
4
Department of Psychiatry, Khyber Medical College, Khyber Pakhtunkhwa 25120, Pakistan
5
Department of Public Health, Harvard School of Public Health, Boston, MA 02115, USA
6
Department of Psychiatry, Brookdale Hospital and Medical Center, Brooklyn, NY 11212, USA
7
Department of Psychiatry, Griffin Memorial Hospital, Norman, OK 73071, USA
*
Author to whom correspondence should be addressed.
Behav. Sci. 2019, 9(10), 105; https://doi.org/10.3390/bs9100105
Received: 28 May 2019 / Revised: 1 September 2019 / Accepted: 24 September 2019 / Published: 29 September 2019
Objective: To evaluate the impact of antepartum mental disorders (AMD) in medical and psychiatric comorbidities, and inpatient outcomes during hospitalizations for pregnancy/birth-related complications. Methods: We used the national inpatient sample (NIS) data and included 19,170,562 female patients (age, 12–40 years) with a principal diagnosis of pregnancy/birth-related complications and grouped by co-diagnoses of AMD (N = 897,397). We used a binomial logistic regression model to evaluate the odds ratio (OR) for major severity of illness and adjusted for demographic confounders. Results: The hospitalizations with AMD increased by 22.1% (p < 0.001) from 2010 to 2014. White females (66.1%) and those from low-income families (<25th percentile, 31.8%) majorly had comorbid AMD. Depression (43.8%) and drug abuse (27%) were prevalent psychiatric disorders in AMD inpatients. Comorbid AMD inpatients had a higher likelihood for major severity of illness (OR 2.475, 95% CI 2.459–2.491, p < 0.001). They also had a longer hospitalization stay with a mean difference of 0.486 days (95% CI 0.480–0.491) and higher total charges by $1889.420 per admission (95% CI 1852.670–1926.170) than non-AMD inpatients. Conclusions: AMD is associated with worsening of severity of illness in pregnancy/birth-related complications and require acute inpatient care. Mental health assessment and treatment of AMD, and education about efficacy and safety of psychiatric medications may help to improve outcomes in these patients. View Full-Text
Keywords: pregnancy; complications; antepartum; mental illness; depression; outcomes; psychiatric disorder pregnancy; complications; antepartum; mental illness; depression; outcomes; psychiatric disorder
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Bhimanadham, N.N.; Mainali, P.; Robert, C.A.; Masroor, A.; Onyeaka, H.K.; Hossain, S.; Patel, R.S. Hospital Outcomes in Antepartum Mental Disorders: A Study on 897,397 Pregnant Inpatients. Behav. Sci. 2019, 9, 105.

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