Skip to main content Accessibility help
×
×
Home

Young pregnant women and risk for mental disorders: findings from an early pregnancy cohort

  • Georgia Lockwood Estrin (a1), Elizabeth G. Ryan (a2), Kylee Trevillion (a3), Jill Demilew (a4), Debra Bick (a5), Andrew Pickles (a6) and Louise Michele Howard (a7)...
Abstract
Background

Young women aged 16–24 are at high risk of common mental disorders (CMDs), but the risk during pregnancy is unclear.

Aims

To 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.

Method

Analysis 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.

Results

Population 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).

Conclusions

Pregnant 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 interest

None.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Young pregnant women and risk for mental disorders: findings from an early pregnancy cohort
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Young pregnant women and risk for mental disorders: findings from an early pregnancy cohort
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Young pregnant women and risk for mental disorders: findings from an early pregnancy cohort
      Available formats
      ×
Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Correspondence: Georgia Lockwood Estrin, Section of Women's Mental Health, PO31 Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK. Email: georgia.lockwood_estrin@kcl.ac.uk
References
Hide All
1Patton, GC, Sawyer, SM, Santelli, JS, Ross, DA, Afifi, R, Allen, NB, et al. Our future: a Lancet commission on adolescent health and wellbeing. Lancet 2016; 387: 2423–78.
2NHS Digital. Mental Health of Children and Young People in England, 2017 [PAS]. NHS Digital, 2018 (https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-of-children-and-young-people-in-england/2017/2017#key-facts).
3McManus, S, Bebbington, P, Bebbington, R, Brugha, T. Mental Health and Wellbeing in England: Adult Psychiatric Morbidity Survey 2014. NHS Digital, 2016.
4Siegel, RS, Brandon, AR. Adolescents, pregnancy, and mental health. J Pediatr Adolesc Gynecol 2014; 27: 138–50.
5Howard, LM, Piot, P, Stein, A. No health without perinatal mental health. Lancet 2014; 384: 1723–4.
6Cox, JE, Buman, M, Valenzuela, J, Joseph, NP, Mitchell, A, Woods, ER. Depression, parenting attributes, and social support among adolescent mothers attending a teen tot program. J Pediatr Adolesc Gynecol 2008; 21: 275–81.
7Hudson, DB, Elek, SM, Campbell-Grossman, C. Depression, self-esteem, loneliness, and social support among adolescent mothers participating in the new parents project. Adolescence 2000; 35: 445–53.
8Elfenbein, DS, Felice, ME. Adolescent pregnancy. Pediatr Clin North Am 2003; 50: 781800.
9Aldridge, H, Born, T, Tinson, A, MacInnes, T. London's Poverty Profile 2015. Trust for London; New Policy Institute, 2015.
10Howard, LM, Ryan, EG, Trevillion, K, Anderson, F, Bick, D, Bye, A, et al. The accuracy of the Whooley questions and the Edinburgh Postnatal Depression Scale in identifying depression and other mental disorders in early pregnancy. Br J Psychiatry 2018; 212: 50–6.
11First, MB, Spitzer, RL, Gibbon, M, Williams, JB. Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition. Biometrics Research, New York State Psychiatric Institute, 2002.
12Zanarini, MC, Frankenburg, FR, Sickel, AE, Yong, L. The Diagnostic Interview for DSM-IV Personality Disorders (DIPD-IV), Vol. 340. McLean Hospital, 1996.
13National Institute for Health and Care Excellence. Research Recommendations: 4.2 Effect of Early Booking on Obstetric and Neonatal Outcomes. Clinical Guideline CG110. NICE, 2010.
14Kiernan, KE, Mensah, FK. Poverty, maternal depression, family status and children's cognitive and behavioural development in early childhood: a longitudinal study. J Soc Policy 2009; 38: 569–88.
15Ferguson, H, Bovaird, S, Mueller, M. The impact of poverty on educational outcomes for children. Paediatr Child Health 2007; 12: 701–6.
16Babor, TF, Higgins-Biddle, JC, Saunders, JB, Monteiro, MG. The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care. World Health Organization: Department of Mental Health and Substance Dependence, 2001.
17Berman, AH, Bergman, H, Palmstierna, T, Schylter, F. DUDIT - The Drug Use Disorder Identification Test. Karolinska Institutet, Department of Clinical Neuroscience, 2003.
18Cox, JL, Holden, J, Sagovsky, R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 1987; 150: 782–6.
19Howard, LM, Flach, C, Mehay, A, Sharp, D, Tylee, A. The prevalence of suicidal ideation identified by the Edinburgh Postnatal Depression Scale in postpartum women in primary care: findings from the RESPOND trial. BMC Pregnancy Childbirth 2011; 11: 57.
20Hegarty, K. Composite Abuse Scale Manual. Department of General Practice, The University of Melbourne, 2007.
21Foa, EB. Posttraumatic Stress Diagnostic Scale Manual. National Computer Systems Inc., 1995.
22Pickles, A, Dunn, G, Vázquez-Barquero, JL. Screening for stratification in two-phase (‘two-stage’) epidemiological surveys. Stat Methods Med Res 1995; 4: 7389.
23Binder, DA. On the variances of asymptotically normal estimators from complex surveys. Int Statist Rev 1983; 51: 279–92.
24Biaggi, A, Conroy, S, Pawlby, S, Pariante, CM. Identifying the women at risk of antenatal anxiety and depression: a systematic review. J Affect Disord 2016; 191: 6277.
25Crawford, DM, Trotter, EC, Hartshorn, KJ, Whitbeck, LB. Pregnancy and mental health of young homeless women. Am J Orthopsychiatry 2011; 81: 173–83.
26Young Women's Trust. Young Women's Trust Annual Survey 2017. Young Women's Trust, 2017.
27IFF Research. Pregnancy and Maternity Related Discrimination and Disadvantage: Experiences of Mothers: IFF Research on behalf of the Department for Business, Innovation and Skills and the Equality and Human Rights Commission. Department for Business, Innovation and Skills, 2015.
28Howard, LM, Trevillion, K, Khalifeh, H, Woodall, A, Agnew-Davies, R, Feder, G. Domestic violence and severe psychiatric disorders: prevalence and interventions. Psychol Med 2010; 40: 881–93.
29Safe Lives. Safe Young Lives: Young People and Domestic Abuse. Safe Lives, 2017.
30Hodgkinson, SC, Colantuoni, E, Roberts, D, Berg-Cross, L, Belcher, HM. Depressive symptoms and birth outcomes among pregnant teenagers. J Pediatr Adolesc Gynecol 2010; 23: 1622.
31Howard, LM, Oram, S, Galley, H, Trevillion, K, Feder, G. Domestic violence and perinatal mental disorders: a systematic review and meta-analysis. PLoS Med 2013; 10: e1001452.
32National Institute for Health and Care Excellence. Domestic Violence and Abuse: How Services Can Respond Effectively. Public Health Guideline (PH50). NICE, 2014.
33Department for Education and Department of Health and Social Care, Transforming Children and Young People's Mental Health Provision: a Green Paper. Department for Education, Department of Health and Social Care, 2017.
34Jahanfar, S, Howard, LM, Medley, N. Interventions for preventing or reducing domestic violence against pregnant women. Cochrane Database Syst Rev 2014; 11: CD009414.
35Lancet. The next phase for adolescent health: from talk to action. Lancet 2017; 390: 1927.
36Perinatal Mental Health Community Services Development Fund. NHS England (https://www.england.nhs.uk/mental-health/perinatal/community-services/).
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

BJPsych Open
  • ISSN: -
  • EISSN: 2056-4724
  • URL: /core/journals/bjpsych-open
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Type Description Title
WORD
Supplementary materials

Lockwood Estrin et al. supplementary material
Tables S1-S3

 Word (37 KB)
37 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Young pregnant women and risk for mental disorders: findings from an early pregnancy cohort

  • Georgia Lockwood Estrin (a1), Elizabeth G. Ryan (a2), Kylee Trevillion (a3), Jill Demilew (a4), Debra Bick (a5), Andrew Pickles (a6) and Louise Michele Howard (a7)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *