title: Use of primary health care prior to a postpartum psychiatric episode.
abstract: OBJECTIVE
  Childbirth is a strong trigger of psychiatric episodes. Nevertheless, use of primary care before these episodes is not quantified. The aim was to study the use of general practice in Denmark from two years before to one year after childbirth in women who developed postpartum psychiatric disorders.
  
  
  METHODS
  A matched cohort study was conducted including women who gave birth in the period 1996-2010. Women were divided into four groups: (i) all mothers with postpartum psychiatric episodes 0-3 months after birth, n = 939; 2: All mothers with a postpartum psychiatric episode 3-12 months after birth, n = 1 436; and (iii) two comparison groups of mothers, total n = 6 630 among 320 620 eligible women.
  
  
  METHODS
  Denmark.
  
  
  METHODS
  Women born in Denmark after 1 January 1960, restricting the cohort to women who gave birth to their first singleton child between 1 January 1996 and 20 October 2010.
  
  
  METHODS
  The main outcome measures were consultation rates, consultation rate ratios, and rate differences.
  
  
  RESULTS
  Women who developed a psychiatric episode after childbirth had higher GP consultation rates before, during, and after the pregnancy. Women with a psychiatric episode 0-3 months postpartum had 6.89 (95% CI 6.60; 7.18) mean number of consultations during pregnancy, corresponding to 1.52 (95% CI 1.22; 1.82) more visits than the comparison group.
  
  
  CONCLUSIONS
  Women with a postpartum psychiatric episode had higher use of GP-based primary health care services years before the childbirth, and in this specific group of patients childbirth itself triggered a marked increase in the number of GP contacts postpartum.
authors.affiliation: National Centre for Register-based Research, Department of Economics and Business; School of Business and Social Sciences, Aarhus University , Denmark , The Initiative for Integrative Psychiatric Research (iPSYCH).
authors.forename: Trine
authors.initials: T
authors.lastname: Munk-Olsen
authors.forename: Henrik Søndergaard
authors.initials: HS
authors.lastname: Pedersen
authors.forename: Thomas Munk
authors.initials: TM
authors.lastname: Laursen
authors.forename: Morten
authors.initials: M
authors.lastname: Fenger-Grøn
authors.forename: Peter
authors.initials: P
authors.lastname: Vedsted
authors.forename: Mogens
authors.initials: M
authors.lastname: Vestergaard
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003695:Delivery of Health Care; D003718:Denmark; D005260:Female; D058006:General Practice; D006801:Humans; D001523:Mental Disorders / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D010342:Patient Acceptance of Health Care; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology; D011295:Prenatal Care; D011320:Primary Health Care; D011618:Psychotic Disorders / Q000209:etiology / Q000628:therapy; D012017:Referral and Consultation; D012307:Risk Factors
keywords: Denmark; depression; general practice; mental disorders; mental health; mothers; patient compliance; postpartum; prenatal care; primary health care