First-time first-trimester induced abortion and risk of readmission to a psychiatric hospital in women with a history of treated mental disorder.
BACKGROUND
Mental health problems are associated with women's reproductive decisions and predict poor mental health outcomes after abortion and childbirth.


OBJECTIVE
To study whether having a first-trimester induced abortion influenced the risk of psychiatric readmission and compare findings with readmission risk in women with mental disorders giving birth.


METHODS
Survival analyses were performed in a population-based cohort study merging data from the Danish Civil Registration System, the Danish Psychiatric Central Register, and the Danish National Hospital Register from January 1,1994, to December 31, 2007.


METHODS
Denmark.


METHODS
All women born in Denmark between 1962 and 1992 with a record of 1 or more psychiatric admissions at least 9 months before a first-time first-trimester induced abortion or childbirth. Main Outcome Measure  Readmission at a psychiatric hospital with any type of mental disorder from 9 months before to 12 months after a first-time first-trimester induced abortion or childbirth.


RESULTS
Relative risk (RR) for readmission risk 9 to 0 months before a first-trimester induced abortion was 0.95 (95% CI, 0.73-1.23) compared with the first year after the abortion. This contrasts with a reduced risk of readmission before childbirth (RR, 0.56; 95% CI, 0.42-0.75) compared with the first year post partum. Proximity to previous psychiatric admission in particular predicted rehospitalization risks in both the abortion and the childbirth group.


CONCLUSIONS
Risk of readmission is similar before and after first-time first-trimester abortion, contrasting with a marked increased in risk of readmission post partum. We speculate that recent psychiatric episodes may influence women's decisions to have an induced abortion; however, this decision does not appear to influence the illness course in women with a history of treated mental disorders.
National Centre for Register-Based Research, University of Aarhus, Aarhus C, Denmark. tmo@ncrr.dk
Trine
T
Munk-Olsen
Thomas Munk
TM
Laursen
Carsten B
CB
Pedersen
Ojvind
O
Lidegaard
Preben Bo
PB
Mortensen
D000028:Abortion, Induced / Q000009:adverse effects / Q000523:psychology*; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D001523:Mental Disorders / Q000209:etiology* / Q000628:therapy; D010359:Patient Readmission / Q000706:statistics & numerical data; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000523:psychology; D012306:Risk; D012307:Risk Factors; D013997:Time Factors