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Termination of Pregnancy and Psychiatric Morbidity

Published online by Cambridge University Press:  02 January 2018

Anne C. Gilchrist
Affiliation:
Department of Child and Adolescent Psychiatry, University of Manchester
Philip C. Hannaford*
Affiliation:
Royal College of General Practitioners, Manchester Research Unit
Peter Frank
Affiliation:
Royal College of General Practitioners, Manchester Research Unit
Clifford R. Kay
Affiliation:
Royal College of General Practitioners, Manchester Research Unit
*
Dr P. C. Hannaford, Royal College of General Practitioners, Manchester Research Unit, Parkway House, Palatine Road, Northenden, Manchester, M22 4DB.

Abstract

Background

We investigated whether reported psychiatric morbidity was increased after termination of pregnancy compared with other outcomes of an unplanned pregnancy.

Method

This was a prospective cohort study of 13 261 women with an unplanned pregnancy. Psychiatric morbidity reported by GPs after the conclusion of the pregnancy was compared in four groups: women who had a termination of pregnancy (6410), women who did not request a termination (6151), women who were refused a termination (379), and women who changed their minds before the termination was performed (321).

Results

Rates of total reported psychiatric disorder were no higher after termination of pregnancy than after childbirth. Women with a previous history of psychiatric illness were most at risk of disorder after the end of their pregnancy, whatever its outcome. Women without a previous history of psychosis had an apparently lower risk of psychosis after termination than postpartum (relative risk RR = 0.4, 95% confidence interval CI = 0.3–0.7), but rates of psychosis leading to hospital admission were similar. In women with no previous history of psychiatric illness, deliberate self-harm (DSH) was more common in those who had a termination (RR 1.7, 95%CI 1.1–2.6), or who were refused a termination (RR 2.9, 95%CI 1.3–6.3).

Conclusions

The findings on DSH are probably explicable by confounding variables, such as adverse social factors, associated both with the request for termination and with subsequent self-harm. No overall increase in reported psychiatric morbidity was found.

Type
Papers
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

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