Evidence map›Paper›PMID 38652472›Full record

ArticleJAMA network open2024

Severe Maternal Morbidity and Mental Health Hospitalizations or Emergency Department Visits.

Asia Blackman, Ugochinyere V Ukah, Robert W Platt, Xiangfei Meng, Gabriel D Shapiro, Isabelle Malhamé, Joel G Ray, Sarka Lisonkova, Darine El-Chaâr, Nathalie Auger and 1 more

Erratum issuedAbstract read
In one paragraph

Article in JAMA network open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  9. Error in Author Affiliations.JAMA network open · 2024
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Asia BlackmanDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Québec, Canada.
Ugochinyere V UkahPregnancy and Child Research Center, HealthPartners Institute, Minneapolis, Minnesota.
Robert W PlattDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Québec, Canada.
Xiangfei MengDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Québec, Canada.
Gabriel D ShapiroDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Québec, Canada.
Isabelle MalhaméCentre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Québec, Canada.
Joel G RayDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
Sarka LisonkovaDepartment of Obstetrics and Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada.
Darine El-ChaârDepartment of Obstetrics and Gynaecology, University of Ottawa, Ottawa, Ontario, Canada.
Nathalie AugerInstitut national de santé publique du Québec, Montréal, Québec, Canada.
Natalie DayanDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Québec, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: Severe maternal morbidity (SMM) can have long-term health consequences for the affected mother. The association between SMM and future maternal mental health conditions has not been well studied. Objective: To assess the association between SMM in the first recorded birth and the risk of hospitalization or emergency department (ED) visits for a mental health condition over a 13-year period. Design, Setting, and Participants: This population-based retrospective cohort study used data from postpartum individuals aged 18 to 55 years with a first hospital delivery between 2008 and 2021 in 11 provinces and territories in Canada, except Québec. Data were analyzed from January to June 2023. Exposure: SMM, defined as a composite of conditions, such as septic shock, severe preeclampsia or eclampsia, severe hemorrhage with intervention, or other complications, occurring after 20 weeks' gestation and up to 42 days after a first delivery. Main Outcomes and Measures: The main outcome was a hospitalization or ED visit for a mental health condition, including mood and anxiety disorders, substance use, schizophrenia, and other psychotic disorder, or suicidality or self-harm event, arising at least 43 days after the first birth hospitalization. Cox regression models generated hazard ratios with 95% CIs, adjusted for baseline maternal comorbidities, maternal age at delivery, income quintile, type of residence, hospital type, and delivery year. Results: Of 2 026 594 individuals with a first hospital delivery, 1 579 392 individuals (mean [SD] age, 30.0 [5.4] years) had complete ED and hospital records and were included in analyses; among these, 35 825 individuals (2.3%) had SMM. Compared with individuals without SMM, those with SMM were older (mean [SD] age, 29.9 [5.4] years vs 30.7 [6.0] years), were more likely to deliver in a teaching tertiary care hospital (40.8% vs 51.1%), and to have preexisting conditions (eg, ≥2 conditions: 1.2% vs 5.3%), gestational diabetes (8.2% vs 11.7%), stillbirth (0.5% vs 1.6%), preterm birth (7.7% vs 25.0%), or cesarean delivery (31.0% vs 54.3%). After a median (IQR) duration of 2.6 (1.3-6.4) years, 1287 (96.1 per 10 000) individuals with SMM had a mental health hospitalization or ED visit, compared with 41 779 (73.2 per 10 000) individuals without SMM (adjusted hazard ratio, 1.26 [95% CI, 1.19-1.34]). Conclusions and Relevance: In this cohort study of postpartum individuals with and without SMM in pregnancy and delivery, there was an increased risk of mental health hospitalizations or ED visits up to 13 years after a delivery complicated by SMM. Enhanced surveillance and provision of postpartum mental health resources may be especially important after SMM.

Indexed as

Emergency Service, HospitalHospitalizationMental DisordersAdolescentAdultCanadaEmergency Room VisitsFemaleHumansMaternal HealthMental HealthMiddle AgedMorbidityPregnancyPregnancy ComplicationsRetrospective Studies

Identifiers

PMID38652472
PMCPMC11040413

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.