Young pregnant women and risk for mental disorders: findings from an early pregnancy cohort
Georgia Lockwood Estrin,
Elizabeth G. Ryan,
Kylee Trevillion,
Jill Demilew,
Debra Bick,
Andrew Pickles,
Louise Michele Howard
Affiliations
Georgia Lockwood Estrin
Senior Research Associate, Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London; and Research Fellow, Centre for Brain and Cognitive Development, Birkbeck College, UK
Elizabeth G. Ryan
Senior Research Fellow, Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London; and Clinical Trials Unit, Warwick Medical School, University of Warwick, UK
Kylee Trevillion
Lecturer, Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Jill Demilew
Consultant Midwife, Women's Health, King's College Hospital NHS Foundation Trust, UK
Debra Bick
Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London; and Professor of Clinical Trials in Maternal Health, Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, UK
Andrew Pickles
Chair in Biostatistics, Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Louise Michele Howard
Professor in Women's Mental Health and Head of the Section of Women's Mental Health, Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London; Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London; and South London and Maudsley NHS Foundation Trust, UK
BackgroundYoung women aged 16–24 are at high risk of common mental disorders (CMDs), but the risk during pregnancy is unclear.AimsTo compare the population prevalence of CMDs in pregnant women aged 16–24 with pregnant women ≥25 years in a representative cohort, hypothesising that younger women are at higher risk of CMDs (depression, anxiety disorders, post-traumatic stress disorder, obsessive–compulsive disorder), and that this is associated with low social support, higher rates of lifetime abuse and unemployment.MethodAnalysis of cross-sectional baseline data from a cohort of 545 women (of whom 57 were aged 16–24 years), attending a South London maternity service, with recruitment stratified by endorsement of questions on low mood, interviewed with the Structured Clinical Interview DSM-IV-TR.ResultsPopulation prevalence estimates of CMDs were 45.1% (95% CI 23.5–68.7) in young women and 15.5% (95% CI 12.0–19.8) in women ≥25, and for ‘any mental disorder’ 67.2% (95% CI 41.7–85.4) and 21.2% (95% CI 17.0–26.1), respectively. Young women had greater odds of having a CMD (adjusted odds ratio (aOR) = 5.8, 95% CI 1.8–18.6) and CMDs were associated with living alone (aOR = 3.0, 95% CI 1.1–8.0) and abuse (aOR = 1.5, 95% CI 0.8–2.8).ConclusionsPregnant women between 16 and 24 years are at very high risk of mental disorders; services need to target resources for pregnant women under 25, including those in their early 20s. Interventions enhancing social networks, addressing abuse and providing adequate mental health treatment may minimise adverse outcomes for young women and their children.Declaration of interestNone.
