Author(s): MunkOlsen T, Laursen TM, Pedersen CB, Lidegaard O, Mortensen PB
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Abstract CONTEXT: Mental health problems are associated with women's reproductive decisions and predict poor mental health outcomes after abortion and childbirth. OBJECTIVES: 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. DESIGN: 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. SETTING: Denmark. PARTICIPANTS: 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.
This article was published in Arch Gen Psychiatry
and referenced in Journal of Depression and Anxiety