Project Summary

Bernard L. Harlow, Ph.D. (Independent Investigator 2003) of Harvard University, using Swedish registry data, has learned that 17% of women hospitalized for a psychiatric condition prior to their first livebirth delivery went on to develop postpartum psychosis after delivery. This represents a rate 85 times that expected among women in the general population and likely explains more than 95% of the incidence of this disorder. Given that women hospitalized for a psychiatric condition prior to their first livebirth appear to represent the primary population at risk for postpartum psychosis, Dr. Harlow now has the opportunity to explore other characteristics within this population that may explain why certain women do and do not go on to develop this highly dangerous disorder. Using the National Medical Birth Registry from Sweden, Dr. Harlow will have records comprising all births since 1973, and an In-Patient Registry of all hospitalizations (psychiatric and nonpsychiatric) since 1973. Linking together these registries will enable him to determine the proportion of women with a history of psychiatric illness that developed a postpartum psychosis after their first delivery. He will then determine whether prenatal or other obstetrical factors are involved in triggering the onset of postpartum psychosis, whether the severity and timing of the illness, or type prepregnancy psychiatric disorder affects the risk of developing postpartum psychosis, and also whether education and single motherhood modifies the risk of postpartum psychosis. He will also have the opportunity to assess to what extent postpartum psychosis occurs in women with no prior psychiatric hospitalizations. Identifying possible prenatal, obstetrical or other lifestyle factors associated with risk of postpartum psychosis may help obstetricians and psychiatrists recognize and more closely monitor pregnant women at the greatest risk for this highly dangerous mental health condition.

Program Area: SCHIZOPHRENIA/PSYCHOTIC DISORDERS\Postpartum Psychosis

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