Abstract
Background
The Childbirth and Mental Illness (CAMI) antenatal service was established in 2007 to provide antenatal care for women with a diagnosed severe mental illness. These women are known to have poorer obstetric and social outcomes, as well as present later and potentially have less engagement with services. We aim to examine how a specialist multidisciplinary clinic has provided a supportive model of care for these women and report associated outcomes.
Methods
The CAMI antenatal database examined records from completed singleton pregnancies over the last 10 years. Antenatal care outcomes include attendance rates, number of antenatal visits and gestation at booking. Obstetric and neonatal outcomes were compared to the Western Australian pregnancy population. Psychosocial outcomes such as child protection referral and psychiatric admission rates are reported for both the antenatal and postnatal period. Analysis of results was undertaken using SPPS.
Results
Of the 412 singleton pregnancies mean gestation of first hospital antenatal appointment was 19.6 weeks (SD 7.8, 6.4-38.4). Presentation in the third trimester was found to occur in 16% of women, mostly related to late transfer of care. Overall, 81.2% of women had 5 or more antenatal appointments with the CAMI antenatal clinic. Whilst concurrent medical morbidity and antenatal complication rates remain higher than the general population, delivery outcomes were comparable. There were no increased rates of intrauterine growth restriction or macrosomia compared to the normal population, with only slightly higher preterm delivery rates at 10.2% (p=0.04).
Conclusion
A multidisciplinary model of care can provide a supported environment for women with a severe mental illness and lead to improve obstetric outcomes.
The Childbirth and Mental Illness (CAMI) antenatal service was established in 2007 to provide antenatal care for women with a diagnosed severe mental illness. These women are known to have poorer obstetric and social outcomes, as well as present later and potentially have less engagement with services. We aim to examine how a specialist multidisciplinary clinic has provided a supportive model of care for these women and report associated outcomes.
Methods
The CAMI antenatal database examined records from completed singleton pregnancies over the last 10 years. Antenatal care outcomes include attendance rates, number of antenatal visits and gestation at booking. Obstetric and neonatal outcomes were compared to the Western Australian pregnancy population. Psychosocial outcomes such as child protection referral and psychiatric admission rates are reported for both the antenatal and postnatal period. Analysis of results was undertaken using SPPS.
Results
Of the 412 singleton pregnancies mean gestation of first hospital antenatal appointment was 19.6 weeks (SD 7.8, 6.4-38.4). Presentation in the third trimester was found to occur in 16% of women, mostly related to late transfer of care. Overall, 81.2% of women had 5 or more antenatal appointments with the CAMI antenatal clinic. Whilst concurrent medical morbidity and antenatal complication rates remain higher than the general population, delivery outcomes were comparable. There were no increased rates of intrauterine growth restriction or macrosomia compared to the normal population, with only slightly higher preterm delivery rates at 10.2% (p=0.04).
Conclusion
A multidisciplinary model of care can provide a supported environment for women with a severe mental illness and lead to improve obstetric outcomes.
| Original language | English |
|---|---|
| Pages (from-to) | 137 |
| Journal | BJOG: an International Journal of Obstetrics and Gynecology |
| Volume | 125 |
| Issue number | S1 |
| Publication status | Published - Mar 2018 |
