TY - JOUR

T1 - Association between neonatal homecare for preterm infants and incidence of severe postpartum depression in mothers

AU - Andersen, Kristine Sarah Hedegaard

AU - Holm, Kristina Garne

AU - Nordentoft, Merete

AU - Hjorthøj, Carsten

PY - 2021

Y1 - 2021

N2 - Background: Understanding the association between neonatal homecare and postpartum depression could contribute to the design of evidence-based interventions to prevent postpartum depression. We aimed to determine whether the change from inpatient stays in neonatal intensive care units to offering neonatal homecare was associated with a reduced incidence rate of severe postpartum depression among mothers who gave birth prematurely. Methods: We conducted a register-based population-wide study of all mothers who gave birth prematurely 1994-2017 to live-born infants and spent at least one night in the Neonatal Intensive Care Unit. We performed an interrupted time series analysis to investigate the incidence rate ratio of severe postpartum depression before and after the implementation of neonatal homecare. Neonatal homecare was implemented between 1994 and 2016. Results: The total population consisted of 46,456 mothers and the median age was 30 years and interquartile range of 27-34 years. Overall 4.5 % of the mothers were diagnosed with severe postpartum depression. Prior to neonatal homecare no change in the incidence of severe postpartum depression was found; (incidence rate ratio=1.01 [95 % confidence interval: 0.97-1.05] every half year, p=0.69). The implementation was associated with a level change with an incidence rate ratio reduction of 23 % (incidence rate ratio=0.77 [95 % confidence interval: 0.64-0.93], p=0.007). Limitations: Limitations include potential underdiagnosis in early periods, lack of randomization, and different periods of implementation of neonatal homecare. Conclusions: We found a possible association between the implementation of neonatal homecare and a 23 % reduced incidence rate of severe postpartum depression among mothers of preterm infants.

AB - Background: Understanding the association between neonatal homecare and postpartum depression could contribute to the design of evidence-based interventions to prevent postpartum depression. We aimed to determine whether the change from inpatient stays in neonatal intensive care units to offering neonatal homecare was associated with a reduced incidence rate of severe postpartum depression among mothers who gave birth prematurely. Methods: We conducted a register-based population-wide study of all mothers who gave birth prematurely 1994-2017 to live-born infants and spent at least one night in the Neonatal Intensive Care Unit. We performed an interrupted time series analysis to investigate the incidence rate ratio of severe postpartum depression before and after the implementation of neonatal homecare. Neonatal homecare was implemented between 1994 and 2016. Results: The total population consisted of 46,456 mothers and the median age was 30 years and interquartile range of 27-34 years. Overall 4.5 % of the mothers were diagnosed with severe postpartum depression. Prior to neonatal homecare no change in the incidence of severe postpartum depression was found; (incidence rate ratio=1.01 [95 % confidence interval: 0.97-1.05] every half year, p=0.69). The implementation was associated with a level change with an incidence rate ratio reduction of 23 % (incidence rate ratio=0.77 [95 % confidence interval: 0.64-0.93], p=0.007). Limitations: Limitations include potential underdiagnosis in early periods, lack of randomization, and different periods of implementation of neonatal homecare. Conclusions: We found a possible association between the implementation of neonatal homecare and a 23 % reduced incidence rate of severe postpartum depression among mothers of preterm infants.

KW - Maternal health

KW - Postpartum affective disorder

KW - Postpartum depression

KW - Preterm delivery

U2 - 10.1016/j.jad.2020.09.110

DO - 10.1016/j.jad.2020.09.110

M3 - Journal article

C2 - 33011524

AN - SCOPUS:85091742171

VL - 278

SP - 453

EP - 459

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

SN - 0165-0327

ER -