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Cited by 12Maternal Mental Health During Pregnancy and PostpartumMaternal and fetal healthcareMaternal and Neonatal Healthcare

Reducing psychiatric illness in the perinatal period: A review and commentary

Open access
Rohr, Jessica, Vahidy, Farhaan S, Bartek, Nicole, Bourassa, Katelynn A, Nanavaty, Namrata R, Antosh, Danielle D, Harms, Konrad P, Stanley, Jennifer L +1 more·2023·World Journal of Psychiatry
DOI 10.5498/wjp.v13.i4.149PMC PMC10130961
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Abstract

Background: Despite the previous long-term decline and a recent increase in maternal mortality, detailed social inequalities in maternal mortality in the United States (US) have not been analyzed.This study examines trends and inequalities in US maternal mortality by maternal race/ethnicity, socioeconomic status, nativity/immigrant status, marital status, area deprivation, urbanization level, and cause of death.Methods: National vital statistics data from 1969 to 2018 were used to compute maternal mortality rates by sociodemographic factors.Mortality trends by deprivation level were analyzed by using censusbased deprivation indices.Rate ratios and log-linear regression were used to model mortality trends and differentials.Results: Maternal mortality declined by 68% between 1969 and 1998.However, there was a recent upturn in maternal mortality, with the rate increasing from 9.9 deaths/100,000 live births in 1999 to 17.4 in 2018.The large racial disparity persisted over time; Black women in 2018 had a 2.4 times higher risk of maternal mortality than White women.During 2013-2017, the rate varied from 7.0 for Chinese women to 42.0 for non-Hispanic Black women.Unmarried status, US-born status, lower education, and rural residence were associated with 50-114% higher maternal mortality risks.Mothers in the most-deprived areas had a 120% higher risk of mortality than those in the most-affluent areas; both absolute and relative disparities in mortality by deprivation level widened between 2002 and 2018.Hemorrhage, pregnancy-related hypertension, embolism, infection, and chronic conditions were the leading causes of maternal death, with 31% of the deaths attributable to indirect obstetric causes. Conclusions and Global Health Implications:Despite the steep long-term decline in US maternal mortality, substantial racial/ethnic, socioeconomic, and rural-urban disparities remain.Monitoring disparities according to underlying social determinants is key to reducing maternal mortality as they give rise to inequalities in social conditions and health-risk factors that lead to maternal morbidity and mortality.

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  • Vulnerability in motherhood is ubiquitous, with estimates between 15% and 21% of the general population experiencing depression and up to 80% of mothers reporting distress of some kind.

    “Epidemiological data revealed that vulnerability in motherhood was ubiquitous with estimates between 15% to 21% of the general population experiencing depression, and up to 80% of mothers reporting distress of some kind (12).”

    From A critical need for the concept of matrescence in perinatal psychiatry (2024) · cites this paper as [12]

    The Introduction (page unavailable) describes perinatal psychiatric illness and depression as common, supporting the broad point that maternal mental-health vulnerability is widespread. It gives different prevalence figures—about 25% for perinatal depression and 7%–15% or 19%–25% for perinatal psychiatric illness by country income group—not 15%–21% depression in the general population. Our copy does not report that up to 80% of mothers experience distress. (LLM, conf=0.82)

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Research works printed but not linked: 4

  1. [52]Depression: The Treatment and Management of Depression in Adults (Updated Edition). Leicester (UK): British Psychological Society; 2010– 22132433
  2. [59]Redshaw M Henderson J Who is actually asked about their mental health in pregnancy and the postnatal period? BMC Psychiatry 2016 16 322 27633660 PMC5025550
  3. [81]Wyatt R Laderman M Botwinick L Mate K Whittington J Achieving health equity: a guide for health care organizations. Cambridge, MA: Institute for Healthcare Improvement. 2016. [cited 1 March 2023]. Available from: https://www.ihi.org/resources/Pages/IHIWhitePapers/Achieving-Health-Equity.aspx
  4. [88]Meichenbaum D Stress inoculation training: A preventative and treatment approach. 2007. [cited 1 March 2023]. Available from: https://psycnet.apa.org/record/2007-14796-019

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Authors
Rohr, J., Vahidy, F. S., Bartek, N., Bourassa, K. A., Nanavaty, N. R., Antosh, D. D., Harms, K. P., Stanley, J. L., & Madan, A.
Affiliations
Houston Methodist (US)
ORCID
Venue
World Journal of Psychiatry
Publisher
Baishideng Publishing Group Inc.
Published
2023-04-19
Volume
13
Issue
4
Pages
149-160
ISSN
2220-3206 (ISSN-L)
DOI
10.5498/wjp.v13.i4.149
PMC
PMC10130961
OpenAlex
W4366285693
Cited by
11
References
88
Citations by year
2026: 3 · 2025: 2 · 2024: 5 · 2023: 1
FWCI
0.54
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • World Journal of Psychiatry (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
Keywords
maternal mortality, perinatal mental health, racial disparities, socioeconomic status, social determinants of health, area deprivation, urban-rural differences, immigrant status, marital status, causes of maternal death, pregnancy-related hypertension, hemorrhage, indirect obstetric causes

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