New perinatal mental health conditions diagnosed during COVID-19: a population-based, retrospective cohort study of birthing people in Ontario

Rebecca H Correia; Devon Greyson; David Kirkwood; Elizabeth K Darling; Manisha Pahwa; Hamideh Bayrampour; Aaron Jones; Cassandra Kuyvenhoven; Jessica Liauw; Meredith Vanstone

doi:10.1007/s00737-024-01534-1

New perinatal mental health conditions diagnosed during COVID-19: a population-based, retrospective cohort study of birthing people in Ontario

Arch Womens Ment Health. 2024 Nov 19. doi: 10.1007/s00737-024-01534-1. Online ahead of print.

Authors

Affiliations

¹ Health Research Methodology graduate program, McMaster University, Hamilton, ON, Canada.
² School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
³ ICES, McMaster University, Hamilton, ON, Canada.
⁴ Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada.
⁵ School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.
⁶ Department of Family Practice, Midwifery Program, University of British Columbia, University Endowment Lands, Vancouver, Canada.
⁷ Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
⁸ Department of Family Medicine, McMaster University, Hamilton, ON, Canada.
⁹ Department of Obstetrics and Gynecology, University of British Columbia, University Endowment Lands, Vancouver, Canada.
¹⁰ Department of Family Medicine, McMaster University, Hamilton, ON, Canada. [email protected].

PMID: 39560777
DOI: 10.1007/s00737-024-01534-1

Abstract

Purpose: We aimed to determine the incidence of mental health diagnoses and associated health and social risk factors among perinatal people in three different COVID-19 phases.

Methods: We conducted a population-based, retrospective cohort study using linked administrative datasets. We included persons with live, in-hospital births in Ontario, Canada from January 1 to March 31 in 2019, 2021, or 2022 (three phases relative to COVID-19 with different public health policy measures). We excluded people with prior mental health diagnoses. We used diagnostic codes to identify new onset of depression, anxiety, or adjustment disorder in the antenatal and postpartum period. We developed multivariable, modified Poisson models to examine associations between sociodemographic and clinical factors and new mental health diagnoses in each phase.

Results: There were 72,242 people in our cohort. Antenatal mental health diagnoses were significantly higher in 2021 (aRR = 1.32; CI = 1.20-1.46) and 2022 (aRR = 1.22; CI = 1.11-1.35) versus 2019. Postpartum diagnoses were significantly greater in 2021 (aRR = 1.16; CI = 1.08-1.25) versus 2019. Antenatal diagnoses were associated with birth year, previous stillbirth, pre-existing hypertension, multiparity, residential instability, and ethnocultural diversity. Postpartum diagnoses were associated with birth year, maternal age, multiparity, care provider profession, assisted reproductive technology, birthing mode, pre-existing hypertension, intensive care admission, hospital readmission, residential instability, and ethnocultural diversity. Family physicians increasingly made mental health diagnoses in 2021 and 2022.

Conclusion: Increased incidence of perinatal mental health diagnoses during COVID-19 suggests complex dynamics involving pandemic and health and social risk factors.

Registration: This study was registered with Clinicaltrials.gov (NCT05663762) on December 21, 2022.

Keywords: Adjustment disorders; Anxiety disorders; COVID-19; Depression; Maternal health services; Postpartum.

Associated data

ClinicalTrials.gov/NCT05663762

Abstract

Associated data

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