Rate of maternal mental illness health outcome within 365 days after the index birth*
| Outcome | Spontaneous conception n = 688 970 | Subfertility without infertility treatment n = 78 283 | Noninvasive infertility treatment n = 9178 | Invasive infertility treatment n = 9633 | ||||
|---|---|---|---|---|---|---|---|---|
| No. of patients* | Rate per 1000 births (95% CI) | No. of patients* | Rate per 1000 births (95% CI) | No. of patients* | Rate per 1000 births (95% CI) | No. of patients* | Rate per 1000 births (95% CI) | |
| Overall composite outcome | 41894 | 60.8 (60.2–61.4) | 4863 | 62.1 (60.4–63.9) | 604 | 65.8 (60.6–71.1) | 582 | 60.4 (55.5–65.3) |
| Diagnosed outpatient mental illness† | 39473 | 57.3 (56.7–57.9) | 4713 | 60.2 (58.5–61.9) | 589 | 64.2 (59.0–69.4) | 565 | 58.7 (53.8–63.5) |
| Substance use disorder | 1074 | 1.6 (1.5–1.7) | 20 | 0.6 (0.1–0.4) | < 6 | – | < 6 | – |
| Psychotic disorder | 1274 | 1.9 (1.8–2.0) | 174 | 2.2 (1.9–2.6) | 23 | 2.5 (1.5–3.5) | 22 | 2.3 (1.3–3.2) |
| Nonpsychotic disorder | 37913 | 55.0 (54.5–55.6) | 4613 | 58.9 (57.2–60.6) | 578 | 63.0 (57.8–68.1) | 552 | 57.3 (52.5–62.1) |
| Time to outcome, mo, median (IQR) | 5.3 (2.4–8.5) | 5.0 (2.1–8.2) | 4.5 (1.8–8.3) | 4.0 (1.8–7.7) | ||||
| Diagnosed severe mental illness‡ | 4832 | 7.0 (6.8–7.2) | 349 | 4.5 (4.0–4.9) | 53 | 5.8 (4.2–7.3) | 36 | 3.7 (2.5–5.0) |
| Substance use disorder | 634 | 0.9 (0.9–1.0) | 15 | 0.2 (0.1–0.3) | < 6 | – | < 6 | – |
| Psychotic disorder | 164 | 0.2 (0.2–0.3) | 19 | 0.2 (0.1–0.4) | < 6 | – | < 6 | – |
| Mood or anxiety disorder | 3878 | 5.6 (5.5–5.8) | 301 | 3.9 (3.4–4.3) | 47 | 5.1 (3.7–6.6) | 34 | 3.5 (2.3–4.7) |
| Deliberate self-harm | 292 | 0.4 (0.4–0.5) | 14 | 0.2 (0.1–0.3) | < 6 | – | < 6 | – |
| Other | 94 | 0.1 (0.1–0.2) | 8 (0.1) | 0.1 (0.03–0.2) | < 6 | – | < 6 | – |
| Time to outcome, mo, median (IQR) | 5.3 (2.3–8.4) | 4.5 (1.6–8.1) | 5.4 (1.2–8.0) | 3.0 (1.2–7.4) | ||||
Note: CI = confidence interval, IQR = interquartile range.
↵* Unless indicated otherwise. Fewer than 6 events are suppressed.
↵† Defined by the presence of 2 or more outpatient visits for a substance use disorder, psychotic disorder, or a nonpsychotic disorder (Appendix 1, eTable 3 contains the respective diagnostic codes).
↵‡ Defined by the presence of 1 or more inpatient hospital admissions or emergency department visits for a substance-related and addictive disorder, schizophrenia spectrum and other psychotic disorder, mood or anxiety disorder, deliberate self-harm event, or other mental illness (Appendix 1, eTable 3 contains the respective diagnostic codes).