title: All-Cause Mortality in Women With Severe Postpartum Psychiatric Disorders.
abstract: The postpartum period is associated with a high risk of psychiatric episodes. The authors studied mortality in women with first-onset severe psychiatric disorders following childbirth and compared their mortality rates with those in women from the background population including other female psychiatric patients (mothers and childless women).
  
  
  
  In a register-based cohort study with linked information from Danish population registers, the authors identified women with first psychiatric inpatient or outpatient contacts 0-3 months postpartum. The main outcome measure was mortality rate ratios (MRRs): deaths from natural causes (diseases and medical conditions) or unnatural causes (suicides, accidents, and homicides). The cohort included 1,545,857 women representing 68,473,423 person-years at risk.
  
  
  
  In total, 2,699 women had first-onset psychiatric disorders 0-3 months postpartum, and 96 of these died during follow-up. Women with postpartum psychiatric disorders had a higher MRR (3.74; 95% CI=3.06-4.57) than non-postpartum-onset mothers (MRR=2.73; 95% CI=2.67-2.79) when compared with mothers with no psychiatric history. However, childless women with psychiatric diagnoses had the highest MRR (6.15; 95% CI=5.94-6.38). Unnatural cause of death represented 40.6% of fatalities among women with postpartum psychiatric disorders, and within the first year after diagnosis, suicide risk was drastically increased (MRR=289.42; 95% CI=144.02-581.62) when compared with mothers with no psychiatric history.
  
  
  
  Women with severe postpartum psychiatric disorders had increased MRRs compared with mothers without psychiatric diagnoses, and the first year after diagnosis represents a time of particularly high relative risk for suicide in this vulnerable group.
authors.affiliation: From the National Center for Register-Based Research and the Center for Integrated Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark; the Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands; and the Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill.
authors.forename: Benedicte Marie Winther
authors.initials: BM
authors.lastname: Johannsen
authors.affiliation: From the National Center for Register-Based Research and the Center for Integrated Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark; the Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands; and the Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill.
authors.forename: Janne Tidselbak
authors.initials: JT
authors.lastname: Larsen
authors.affiliation: From the National Center for Register-Based Research and the Center for Integrated Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark; the Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands; and the Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill.
authors.forename: Thomas Munk
authors.initials: TM
authors.lastname: Laursen
authors.affiliation: From the National Center for Register-Based Research and the Center for Integrated Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark; the Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands; and the Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill.
authors.forename: Veerle
authors.initials: V
authors.lastname: Bergink
authors.affiliation: From the National Center for Register-Based Research and the Center for Integrated Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark; the Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands; and the Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill.
authors.forename: Samantha
authors.initials: S
authors.lastname: Meltzer-Brody
authors.affiliation: From the National Center for Register-Based Research and the Center for Integrated Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark; the Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands; and the Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill.
authors.forename: Trine
authors.initials: T
authors.lastname: Munk-Olsen
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002423:Cause of Death; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D001523:Mental Disorders / Q000401:mortality*; D049590:Postpartum Period / Q000523:psychology*; D011644:Puerperal Disorders / Q000401:mortality* / Q000523:psychology*; D012042:Registries; D013405:Suicide / Q000706:statistics & numerical data; D016019:Survival Analysis; D055815:Young Adult