School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
School of Nursing and Midwifery, University of Technology, Broadway, Sydney, NSW, 2007, Australia.
BMC Pregnancy Childbirth. 2022 May 21;22(1):428. doi: 10.1186/s12884-022-04736-6.
There is a tiered healthcare system in Australia to support maternal and child health, including, non-psychiatric day stay and residential parenting services (RPS) such as Tresillian and Karitane (in New South Wales [NSW]). RPS are unique to Australia, and currently there is limited information regarding the healthcare trajectory of women accessing RPS and if they are more likely to have admissions to other health facilities within the first-year post-birth. This study aimed to examine differences in hospital co-admissions for women and babies admitted to RPS in NSW in the year following birth compared to non-RPS admitted women.
A linked population data study of all women giving birth in NSW 2000-2012. Statistical differences were calculated using chi-square and student t-tests.
Over the 12-year timeframe, 32,071 women and 33,035 babies were admitted to RPS, with 5191 of these women also having one or more hospital admissions (7607 admissions). The comparator group comprised of 99,242 women not admitted to RPS but having hospital admissions over the same timeframe (136,771 admissions). Statistically significant differences between cohorts were observed for the following parameters (p ≤ .001). Based upon calculated percentages, women who were admitted to RPS were more often older, Australian born, socially advantaged, private patients, and having their first baby. RPS admitted women also had more multiple births and labour and birth interventions (induction, instrumental birth, caesarean section, epidural, episiotomy). Their infants were also more often male and admitted to Special Care Nursery/Neonatal Intensive Care. Additionally, RPS admitted women had more admissions for mental health and behavioural disorders, which appeared to increase over time. There was no statistical difference between cohorts regarding the number of women admitted to a psychiatric facility; however, women attending RPS were more likely to have mood affective, or behavioural and personality disorder diagnoses.
Women accessing RPS in the year post-birth were more socially advantaged, had higher birth intervention and more co-admissions and treatment for mental health disorders than those not accessing RPS. More research is needed into the impact of birth intervention and mental health issues on subsequent parenting difficulties.
澳大利亚有一个分层的医疗保健系统,为母婴健康提供支持,包括非精神病日间住院和住宅育儿服务(RPS),如 Tresillian 和 Karitane(在新南威尔士州[NSW])。RPS 是澳大利亚独有的,目前关于接受 RPS 的妇女的医疗保健轨迹的信息有限,以及她们在产后第一年是否更有可能入住其他医疗机构。本研究旨在比较新南威尔士州 RPS 入院和非 RPS 入院妇女在产后一年内入住其他医疗机构的差异。
对 2000-2012 年在新南威尔士州分娩的所有妇女进行的一项人口数据关联研究。使用卡方检验和学生 t 检验计算统计差异。
在 12 年的时间内,有 32071 名妇女和 33035 名婴儿入住 RPS,其中 5191 名妇女还进行了一次或多次住院治疗(7607 次)。对照组包括在同一时期未入住 RPS 但住院治疗的 99242 名妇女(136771 次)。在以下参数方面,观察到队列之间存在显著差异(p≤0.001)。基于计算出的百分比,入住 RPS 的妇女年龄更大、澳大利亚出生、社会地位较高、是私人患者,并且是第一次生育。入住 RPS 的妇女也有更多的多胎分娩和分娩干预(引产、器械分娩、剖腹产、硬膜外麻醉、会阴切开术)。她们的婴儿也更常是男性,并被送入特殊护理婴儿室/新生儿重症监护室。此外,入住 RPS 的妇女因心理健康和行为障碍而入院的次数更多,且随着时间的推移似乎有所增加。入住精神病院的妇女在两个队列之间没有统计学差异;然而,入住 RPS 的妇女更有可能被诊断为情绪障碍、情感障碍、行为和人格障碍。
产后一年内接受 RPS 治疗的妇女比未接受 RPS 治疗的妇女社会地位更高,分娩干预更多,并且更有可能同时入院并接受心理健康障碍治疗。需要进一步研究分娩干预和心理健康问题对后续育儿困难的影响。