Stratification of the risk of bipolar disorder recurrences in pregnancy and postpartum.

Di Florio, Arianna, Gordon-Smith, Katherine, Forty, Liz, Kosorok, Michael R, Fraser, Christine, Perry, Amy ORCID: 0000-0002-9381-6636, Bethell, Andrew ORCID: 0000-0002-6792-9143, Craddock, Nick, Jones, Lisa and Jones, Ian (2018) Stratification of the risk of bipolar disorder recurrences in pregnancy and postpartum. The British journal of psychiatry : the journal of mental science, 213 (3). pp. 542-547.

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Official URL: http://dx.doi.org/10.1192/bjp.2018.92

Abstract

<h4>Background</h4>Pregnancy and childbirth are a period of high risk for women with bipolar disorder and involve difficult decisions particularly about continuing or stopping medications.AimsTo explore what clinical predictors may help to individualise the risk of perinatal recurrence in women with bipolar disorder.<h4>Method</h4>Information was gathered retrospectively by semi-structured interview, questionnaires and case-note review from 887 women with bipolar disorder who have had children. Clinical predictors were selected using backwards stepwise logistic regression, conditional permutation random forests and reinforcement learning trees.<h4>Results</h4>Previous perinatal history of affective psychosis or depression was the most significant predictor of a perinatal recurrence (odds ratio (OR) = 8.5, 95% CI 5.04-14.82 and OR = 3.6, 95% CI 2.55-5.07 respectively) but even parous women with bipolar disorder without a previous perinatal mood episode were at risk following a subsequent pregnancy, with 7% developing postpartum psychosis.<h4>Conclusions</h4>Previous perinatal history of affective psychosis or depression is the most important predictor of perinatal recurrence in women with bipolar disorder and can be used to individualise risk assessments.Declaration of interestNone.

Item Type:	Article
Uncontrolled Keywords:	Humans, Pregnancy Complications, Recurrence, Multivariate Analysis, Logistic Models, Risk Assessment, Risk Factors, Retrospective Studies, Depression, Affective Disorders, Psychotic, Bipolar Disorder, Postpartum Period, Pregnancy, Diagnostic and Statistical Manual of Mental Disorders, Adult, Aged, Aged, 80 and over, Middle Aged, Female, Young Adult, Surveys and Questionnaires, United Kingdom
Depositing User:	Symplectic Admin
Date Deposited:	01 Jul 2019 15:53
Last Modified:	17 Mar 2024 22:30
DOI:	10.1192/bjp.2018.92
Open Access URL:	https://doi.org/10.1192/bjp.2018.92
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3048203