title: Obstetric variables associated with bipolar affective puerperal psychosis.
abstract: BACKGROUND
  Previous cross-sectional studies have highlighted a number of obstetric variables that may be associated with the development of broadly defined puerperal (post-partum) psychosis. These include: (a) primiparity, (b) pregnancy complications, (c) delivery complications, (d) Caesarean section, (e) female baby and (f) shorter gestation period.
  
  
  OBJECTIVE
  To examine these risk factors in women with well-characterised bipolar affective puerperal psychosis.
  
  
  METHODS
  A sample of 129 women with bipolar affective puerperal psychosis were investigated using a design that takes advantage of within-subject comparisons of affected and unaffected deliveries.
  
  
  RESULTS
  Two of the variables studied were independently associated with an episode of puerperal psychosis: primiparity (odds ratio=3.76, P < 0.001) and delivery complications (odds ratio=2.68, P=0.022).
  
  
  CONCLUSIONS
  This study provides further evidence of the association between primiparity and puerperal psychosis and suggests that complications during delivery may be associated with a severe post-partum episode.
authors.affiliation: Neuropsychiatric Genetics Unit, Department of Psychological Medicine, University of Cardiff, Heath Park, Cardiff CF14 4XN, Wales, UK.
authors.forename: Emma Robertson
authors.initials: ER
authors.lastname: Blackmore
authors.forename: Ian
authors.initials: I
authors.lastname: Jones
authors.forename: Monica
authors.initials: M
authors.lastname: Doshi
authors.forename: Sayeed
authors.initials: S
authors.lastname: Haque
authors.forename: Roger
authors.initials: R
authors.lastname: Holder
authors.forename: Ian
authors.initials: I
authors.lastname: Brockington
authors.forename: Nick
authors.initials: N
authors.lastname: Craddock
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000209:etiology*; D003430:Cross-Sectional Studies; D019052:Depression, Postpartum / Q000209:etiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D007744:Obstetric Labor Complications / Q000523:psychology*; D010298:Parity; D011247:Pregnancy; D012307:Risk Factors; D006113:United Kingdom