Abstract
Objective This study aimed to assess risk for postpartum psychiatric admissions in the United
States.
Study Design This study used the 2010 to 2014 Nationwide Readmissions Database to identify psychiatric
admissions during the first 60 days after delivery hospitalization. Timing of admission
after delivery discharge was determined. We fit multivariable log-linear regression
models to assess the impact of psychiatric comorbidity on admission risk, adjusting
for patient, obstetrical, and hospital factors.
Results Of 15.7 million deliveries from 2010 to 2014, 11,497 women (0.07%) were readmitted
for a primary psychiatric diagnosis within 60 days postpartum. Psychiatric admissions
occurred relatively consistently across 10-day periods after delivery hospitalization
discharge. Psychiatric diagnoses were present among 5% of women at delivery but 40%
of women who were readmitted postpartum for a psychiatric indication. In the adjusted
model, women with psychiatric diagnoses at delivery hospitalization were 9.7 times
more likely to be readmitted compared with those without psychiatric comorbidity.
Women at highest risk for psychiatric admission were those with Medicare and Medicaid,
in lower income quartiles, and of younger age.
Conclusion While a large proportion of psychiatric admissions occurred among a relatively small
proportion of at-risk women, admissions occurred over a broad temporal period relative
to other indications for postpartum admission.
Keywords
postpartum depression - psychiatric readmissions - obstetric conditions - maternal
risk