Risk factors associated with childbearing-related episodes in women with bipolar disorder.
OBJECTIVE
For the onset of illness and possible recurrence during the childbearing period, women with bipolar disorder (BD) are at a higher risk. The aim of this study was to evaluate the impact of clinical and psychosocial factors associated with pregnancy and the postpartum period on the course of BD.


METHODS
The childbearing and illness history of 72 women with BD were assessed to determine mood episodes related to the childbearing period. Data was analyzed to evaluate the risk factors (clinical, obstetric and psychosocial factors) related with mood episodes during pregnancy and the postpartum period.


RESULTS
Data of 252 pregnancies and childbirths of 72 women with BD were included in the analysis. Twenty-three (32%) women with BD reported at least one mood episode during pregnancy or within 1 month after childbirth (childbearing-related episode, CBRE). Subjects with CBREs mean age at onset of illness and mean age at the time of assessment were significantly younger than subjects with N-CBRE. A lower number of women who experienced a postpartum episode after the birth of the first child chose to have the second one. Psychosocial factors during pregnancy and the postpartum period and method of delivery did not predict the first postpartum episode. Onset of illness at an early age, experiencing episode during the first pregnancy and experiencing physical problems during pregnancy predicted a mood episode during the first postpartum period.


CONCLUSIONS
Interpretation of the results of the study is limited with the retrospective nature of data collection. Within the limitations, we may suggest that psychosocial factors do not play a significant role in the genesis of CBREs in women with BD.
Ege University School of Medicine, Department of Psychiatry, Izmir, Turkey. akdeniz@med.ege.edu.tr
Fisun
F
Akdeniz
Simavi
S
Vahip
Sebnem
S
Pirildar
Isil
I
Vahip
Inci
I
Doganer
Ilksen
I
Bulut
D000328:Adult; D000339:Affect; D001714:Bipolar Disorder / Q000150:complications* / Q000523:psychology*; D019052:Depression, Postpartum / Q000209:etiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors