Postpartum Mental Illness During the COVID-19 Pandemic: a Population-based, Repeated Cross-sectional Study

Overview

Journal CMAJ

Date 2021 Jun 8

PMID 34099467

Citations 21

Authors

Simone N Vigod

Hilary K Brown

Anjie Huang

Kinwah Fung

Lucy C Barker

Neesha Hussain-Shamsy

Elisabeth Wright

Cindy-Lee Dennis

Sophie Grigoriadis

Peter Gozdyra

Daniel Corsi

Mark Walker

Rahim Moineddin

Affiliations

Soon will be listed here.

Abstract

Background: It is unclear whether the clinical burden of postpartum mental illness has increased during the COVID-19 pandemic. We sought to compare physician visit rates for postpartum mental illness in Ontario, Canada, during the pandemic with rates expected based on prepandemic patterns.

Methods: In this population-based, repeated cross-sectional study using linked health administrative databases in Ontario, Canada, we used negative binomial regression to model expected visit rates per 1000 postpartum people for March-November 2020 based on prepandemic data (January 2016-February 2020). We compared observed visit rates to expected visit rates for each month of the pandemic period, generating absolute rate differences, incidence rate ratios (IRRs) and their 95% confidence intervals (CIs). The primary outcome was a visit to a primary care physician or a psychiatrist for any mental disorder. We stratified analyses by maternal sociodemographic characteristics.

Results: In March 2020, the visit rate was 43.5/1000, with a rate difference of 3.11/1000 (95% CI 1.25-4.89) and an IRR of 1.08 (95% CI 1.03-1.13) compared with the expected rate. In April, the rate difference (10.9/1000, 95% CI 9.14-12.6) and IRR (1.30, 95% CI 1.24-1.36) were higher; this level was generally sustained through November 2020. From April-November, we observed elevated visit rates across provider types and for diagnoses of anxiety, depressive and alcohol or substance use disorders. Observed increases from expected visit rates were greater for people 0-90 days postpartum compared with 91-365 days postpartum; increases were small among people living in low-income neighbourhoods. Public health units in the northern areas of the province did not see sustained elevations in visit rates after July; southern health units had elevated rates through to November.

Interpretation: Increased visits for mental health conditions among postpartum people during the first 9 months of the COVID-19 pandemic suggest an increased need for effective and accessible mental health care for this population as the pandemic progresses.

Citing Articles

The Impact of Covid-19 on Women's Mental Health and Wellbeing During Pregnancy and the Perinatal Period: A Mixed-Methods Systematic Review.

Pankaew K, Carpenter D, Kerdprasong N, Nawamawat J, Krutchan N, Brown S Inquiry. 2024; 61:469580241301521.

PMID: 39584572 PMC: 11587184. DOI: 10.1177/00469580241301521.

Women's mental health and COVID-19: increased vulnerability and inequalities.

Arilha M, Carvalho A, Forster T, Rodrigues C, Briguglio B, Serruya S Front Glob Womens Health. 2024; 5:1414355.

PMID: 39416672 PMC: 11480059. DOI: 10.3389/fgwh.2024.1414355.

Strategies to support maternal and early childhood wellness: insight from parent and provider qualitative interviews during the COVID-19 pandemic.

Simpson A, Baxter N, Sorvari A, Boury H, Shore E, Bogler T BMJ Open. 2024; 14(1):e079479.

PMID: 38272559 PMC: 10824034. DOI: 10.1136/bmjopen-2023-079479.

Postpartum Psychosis: A Review of Risk Factors, Clinical Picture, Management, Prevention, and Psychosocial Determinants.

Michalczyk J, Milosz A, Soroka E Med Sci Monit. 2023; 29:e942520.

PMID: 38155489 PMC: 10759251. DOI: 10.12659/MSM.942520.

Utilization of physician mental health services by birthing parents with young children during the COVID-19 pandemic: a population-based, repeated cross-sectional study.

Moin J, Vigod S, Plumptre L, Troke N, Papanicolas I, Wodchis W CMAJ Open. 2023; 11(6):E1093-E1101.

PMID: 38016758 PMC: 10699288. DOI: 10.9778/cmajo.20220239.

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