Shlomi-Polachek Inbal, Fung Kinwah, Meltzer-Brody Samantha, Vigod Simone N
Reproductive Life Stages Program, Women's Mental Health Program, Women's College Hospital, 76 Grenville street Rm. 7234, Toronto, ON, M5S 1B2, Canada.
Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
Arch Womens Ment Health. 2017 Aug;20(4):505-513. doi: 10.1007/s00737-017-0733-x. Epub 2017 May 26.
About 1-2/1000 of postpartum women require psychiatric admission. Length of stay is variable, and little is known about short postpartum admission. From all women in Ontario, Canada, with a psychiatric admission within 1 year postpartum (2007-2012) (n = 1702), we compared women with admissions <72 h to women with longer admissions on sociodemographics, clinical characteristics and post-discharge mental health service use. About 37% of admissions were <72 h. These women were more likely to be adolescents (11.7 vs 7.3%), less likely to be employed (16.6 vs 25.9%) compared to women with longer admissions, and fewer had a prior history of psychiatric admission (16.7 vs 59.0%). Index diagnoses of alcohol or substance use (12.5 vs 7.8%) and adjustment disorders (15.8 vs 6.3%) were more common in the short vs longer stay group; psychotic (5.8 vs 19.5%) and bipolar disorders (2.1 vs 14.2%) were less common. Women with short admission were at higher crude risk for ED revisit 7 days post-discharge (11.4 vs 4.9% OR2.52, 95% CI1.74-3.66) and at lower adjusted risk for readmission at 365 days post-discharge (19.5 vs 28.8%, aOR 0.63, 95% CI 0.46-0.85). Women with short stay postpartum admissions are a clinically distinct group that may benefit from targeted intervention.
约千分之一至千分之二的产后女性需要精神科住院治疗。住院时间长短不一，对于产后短期住院情况了解甚少。在加拿大安大略省所有产后1年内（2007 - 2012年）有精神科住院记录的女性（n = 1702）中，我们比较了住院时间小于72小时的女性与住院时间较长的女性在社会人口统计学、临床特征及出院后心理健康服务利用方面的情况。约37%的住院时间小于72小时。与住院时间较长的女性相比，这些女性更可能是青少年（11.7%对7.3%），就业可能性更小（16.6%对25.9%），且既往有精神科住院史的更少（16.7%对59.0%）。短期住院组酒精或物质使用障碍（12.5%对7.8%）及适应障碍（15.8%对6.3%）的首次诊断更为常见；而精神病性障碍（5.8%对19.5%）和双相情感障碍（2.1%对14.2%）则较少见。短期住院女性出院7天后急诊复诊的粗风险更高（11.4%对4.9%，OR 2.52，95% CI 1.74 - 3.66），而出院365天后再次入院的校正风险更低（19.5%对28.8%，aOR 0.63，95% CI 0.46 - 0.85）。产后短期住院女性是一个临床上有明显特征的群体，可能会从针对性干预中获益。
