Eigbike Mercy, Baer Rebecca J, Nidey Nichole, Byatt Nancy, Ramirez Xavier R, Huang Hsiang, Clark Crystal T, Schools-Cropper Avareena, Oltman Scott P, Jelliffe-Pawlowski Laura L, Ryckman Kelli K, Tabb Karen M
Department of Psychiatry and Psychology, Carle Foundation Hospital, Urbana, IL, United States.
Carle Illinois College of Medicine, Urbana, IL, United States.
Front Psychiatry. 2025 May 16;16:1550634. doi: 10.3389/fpsyt.2025.1550634. eCollection 2025.
Mental health conditions are the leading cause of preventable maternal mortality and morbidity, yet few investigations have examined perinatal bipolar disorders. This study sought to examine racial differences in the odds of having a bipolar disorder diagnosis in perinatal women across self-reported racial groups in a large sample in California, USA.
This cross-sectional study uses data from 3,831,593 women who had singleton live births in California, USA from 2011 to 2019 existing in a linked dataset which included hospital discharge records and birth certificates. International Classification of Diseases codes were used to identify women with a bipolar disorder diagnosis code on the hospital discharge record. Medical charts and birth certificate data was used to extract information on clinical and demographic covariate characteristics. Multivariable logistic regression was used to estimate the odds of having a bipolar disorder diagnosis across different self-reported racial groups.
We identified 19,262 women with bipolar disorder diagnoses. Differences in the presence of a bipolar disorder diagnosis emerged by self-reported race. In the fully adjusted model, Multiracial (selection of two races self-reported) women, compared to single-race White women had the highest odds of having a bipolar disorder diagnosis. Further examination of the all-inclusive Multiracial category revealed differences across subgroups where White/Black, White/American Indian Alaskan Native, and Black/American Indian Alaskan Native women had increased odds for bipolar disorder compared to single race White women.
Differences in bipolar disorder diagnoses exist across racial categories and when compared to White women, Multiracial women had the highest odds of bipolar disorder and thus represent a perinatal population of focus for future intervention studies. The increased burden of mental health problems among Multiracial women is consistent with recent research that employs disaggregated race data. More studies of Multiracial women are needed to determine how self-reported racial categories are related to increased risk for perinatal bipolar disorder.
心理健康状况是可预防的孕产妇死亡和发病的主要原因，但很少有研究调查围产期双相情感障碍。本研究旨在在美国加利福尼亚州的一个大样本中，研究不同自我报告种族群体的围产期妇女被诊断为双相情感障碍的几率的种族差异。
这项横断面研究使用了2011年至2019年在美国加利福尼亚州单胎活产的3,831,593名妇女的数据，这些数据存在于一个关联数据集中，该数据集包括医院出院记录和出生证明。使用国际疾病分类代码来识别医院出院记录上有双相情感障碍诊断代码的妇女。利用病历和出生证明数据提取临床和人口统计学协变量特征信息。多变量逻辑回归用于估计不同自我报告种族群体中被诊断为双相情感障碍的几率。
我们识别出19,262名被诊断为双相情感障碍的妇女。双相情感障碍诊断的存在因自我报告的种族而出现差异。在完全调整模型中，与单一种族的白人女性相比，多种族（自我报告选择两个种族）女性被诊断为双相情感障碍的几率最高。对所有包含的多种族类别进行进一步检查发现，不同亚组之间存在差异，其中白人/黑人、白人/美洲印第安阿拉斯加原住民和黑人/美洲印第安阿拉斯加原住民女性被诊断为双相情感障碍的几率比单一种族的白人女性更高。
双相情感障碍诊断在不同种族类别中存在差异，与白人女性相比，多种族女性患双相情感障碍的几率最高，因此是未来干预研究的重点围产期人群。多种族女性心理健康问题负担的增加与最近采用分类种族数据的研究一致。需要更多关于多种族女性的研究来确定自我报告的种族类别与围产期双相情感障碍风险增加之间的关系。
