Rohr Jessica C, Ramirez Pedro T, Vahidy Farhaan S, Madan Alok
Department of Psychiatry and Behavioral Health, Houston Methodist Hospital (Rohr, and Madan), Houston, TX.
Department of Obstetrics and Gynecology, Neal Cancer Center, Houston Methodist Hospital (Ramirez), Houston, TX.
AJOG Glob Rep. 2025 May 18;5(3):100511. doi: 10.1016/j.xagr.2025.100511. eCollection 2025 Aug.
Rates of maternal morbidity and mortality are a global health crisis, and perinatal psychiatric illness is the most common morbidity in pregnancy. Racial, ethnic, and socioeconomic disparities in perinatal psychiatric illness contribute to disparities in maternal morbidity and mortality. There is limited data on diagnosis rates across race/ethnicity and neighborhood deprivation.
To identify prevalence of perinatal psychiatric illness diagnosis and determine differences based on race, ethnicity, and neighborhood deprivation.
This cross-sectional study included women who gave birth between 2020 and 2023 at a Houston Methodist hospital. Houston Methodist is a hospital system serving the greater Houston area. During the study period, 20 015 women received perinatal care from and delivered at a Houston Methodist system hospital. The first birth per individual was used for analyses. 2 women were removed due to missing data. A final 20 013 were eligible for inclusion. Variables of interest included neighborhood deprivation, defined as a score on the Area Deprivation Index, a validated socioeconomic measure, and self-reported race and ethnicity as reported in electronic health record. The main a priori outcome was any psychiatric illness diagnosed between estimated date of conception and 3 months postpartum.
The sample was distributed across race and ethnicity, with 2 098 (10.5%) Asian, 2 893 (14.5%) Black, 5 208 (26.0%) Hispanic White, 8 218 (41.1%) non-Hispanic White, and 1596 (8.0%) other. Mean age of women included in our analyses was 30.50 years (SD= 5.33). Perinatal psychiatric illness was diagnosed in 19.1% of patients. Non-Hispanic White women were diagnosed at the highest rates (24.8%), while Asian women were diagnosed at the lowest rates (9.1%). Rates trended higher as area deprivation increases across the total sample. However, this trend only held for non-Hispanic White women, for whom higher deprivation has significantly higher prevalence rates than lower deprivation (30.6% vs 18.7%, <.001).
One in five women in our study was diagnosed with perinatal psychiatric illness. Our stratified findings were inconsistent with previous reports of higher symptom burden in women of color. Neighborhood deprivation has differential impact depending on race/ethnicity, highlighting the importance of accounting for sociocultural variables when analyzing prevalence.
孕产妇发病率和死亡率是全球性的健康危机，围产期精神疾病是孕期最常见的发病情况。围产期精神疾病在种族、民族和社会经济方面的差异导致了孕产妇发病率和死亡率的差异。关于不同种族/民族和社区贫困程度的诊断率数据有限。
确定围产期精神疾病诊断的患病率，并根据种族、民族和社区贫困程度确定差异。
这项横断面研究纳入了2020年至2023年在休斯顿卫理公会医院分娩的女性。休斯顿卫理公会是一个服务于大休斯顿地区的医院系统。在研究期间，20015名女性在休斯顿卫理公会系统医院接受围产期护理并分娩。分析采用每个人的首次分娩数据。2名女性因数据缺失被排除。最终20013名符合纳入标准。感兴趣的变量包括社区贫困程度，定义为地区贫困指数得分，这是一种经过验证的社会经济指标，以及电子健康记录中自我报告的种族和民族。主要的先验结果是在预计受孕日期至产后3个月期间诊断出的任何精神疾病。
样本在种族和民族上分布广泛，其中亚洲人2098名（10.5%），黑人2893名（14.5%），西班牙裔白人5208名（26.0%），非西班牙裔白人8218名（41.1%），其他1596名（8.0%）。纳入分析的女性平均年龄为30.50岁（标准差=5.33）。19.1%的患者被诊断患有围产期精神疾病。非西班牙裔白人女性的诊断率最高（24.8%），而亚洲女性的诊断率最低（9.1%）。在整个样本中，随着地区贫困程度的增加，发病率呈上升趋势。然而，这种趋势仅适用于非西班牙裔白人女性，她们中贫困程度较高者的患病率显著高于贫困程度较低者（30.6%对18.7%，<.001）。
我们研究中五分之一的女性被诊断患有围产期精神疾病。我们的分层研究结果与之前关于有色人种女性症状负担较重的报道不一致。社区贫困程度对不同种族/民族有不同影响，这凸显了在分析患病率时考虑社会文化变量的重要性。
