title: An audit of pregnant women with severe mental illness referred during the first 2 years of a new perinatal mental health service.
abstract: The importance of identifying pregnant women at high risk of postpartum psychotic illness has been highlighted by recent enquiries and guidelines. It has been recommended that these women are referred to perinatal mental health services, and that individualised care plans are made prior to delivery. This audit describes a cohort of 45 women, referred to a new perinatal mental health service, with a history of psychotic illness or at risk of developing a postpartum psychotic episode. It describes the characteristics of this group, and the outcomes in terms of relapse and whether their children remained in their care. Thirty-nine women (87%) were seen for assessment. Sixty-seven per cent were under the care of a community mental health team. Twenty-one (53.8%) were well at the time of referral. Planned pregnancies were uncommon (15%). All women seen antenatally had care plans written to address the high risk of postpartum relapse. Ten (26%) women had psychiatric admissions during pregnancy. Fifteen (38%) relapsed or had admissions during the first postpartum year. At 1 year postpartum, 74% women had care of their children; 18% children had been adopted or were in foster care; and the outcome was unknown for 8%.
authors.affiliation: MAPPIM Team, South London and Maudsley NHS Foundation Trust, Adamson Centre, St Thomas' Hospital, London, UK. Lucinda.Green@slam.nhs.uk
authors.forename: Lucinda
authors.initials: L
authors.lastname: Green
authors.forename: Sandra
authors.initials: S
authors.lastname: Elliott
authors.forename: Lubna
authors.initials: L
authors.lastname: Anwar
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Best
authors.forename: Manu
authors.initials: M
authors.lastname: Tero
authors.forename: Anindita
authors.initials: A
authors.lastname: Sarkar
authors.forename: Mary
authors.initials: M
authors.lastname: Ross-Davie
authors.forename: Andrew
authors.initials: A
authors.lastname: Hodgkiss
authors.forename: Myra
authors.initials: M
authors.lastname: Hunter
authors.forename: Anne
authors.initials: A
authors.lastname: Boocock
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003156:Community Mental Health Services / Q000458:organization & administration*; D003863:Depression / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008485:Medical Audit / Q000706:statistics & numerical data*; D008603:Mental Health; D009035:Mothers / Q000523:psychology / Q000706:statistics & numerical data*; D020380:Needs Assessment / Q000706:statistics & numerical data; D011247:Pregnancy; D011295:Prenatal Care / Q000458:organization & administration*; D012720:Severity of Illness Index