Background
Methods
Setting and data source
Participants and recruitment
Procedure
Measures
Perinatal mental health information
Domains of perinatal psychosocial assessment
Maternity hospital sector (index birth)
Sociodemographic characteristics
Ethics
Statistical analysis
Results
Characteristic | Study participants | General population | ALSWH |
---|---|---|---|
1973-1978 Cohort* | |||
% | % | % | |
Partner status
§
| |||
Married/de facto | 96.2 | 91.8 | 77.4 |
Single/separated/divorced/widowed | 3.4 | 6.4 | 22.6 |
Missing/not stated
| 0.4 | 1.8 | 0.4 |
Parity
§
| |||
Primiparous | 21.9 | 30.7 | 30.6 |
Multiparous | 78.1 | 69.2 | 69.4 |
Missing/not stated
| - | 0.1 |
-
|
Income management
| |||
Not difficult | 58.8 | 59.4 | |
Difficult | 40.7 | n.a. | 40.1 |
Missing/not stated
| 0.4 | 0.4 | |
Highest level of education
#
| |||
University degree | 59.6 | 23.5 | 50.8 |
Yr 12/Trade/ diploma | 35.4 | 49.7 | 39.6 |
Year 10 or below | 4.3 | 20.5 | 7.4 |
Missing/not stated
| 0.6 | 6.3 | 2.2 |
Area of residence
#
| |||
Urban1
| 58.3 | 68.2 | 54.6 |
Non-urban2
| 41.2 | 31.8 | 41.2 |
Missing/not stated
| 0.5 | 0.1 | 4.2 |
Background language
#
| |||
English | 93.6 | 75.6 | 92.8 |
Non-English speaking | 5.7 | 24.1 | 6.2 |
Missing/not stated
| 0.8 | 0.3 | 1.0 |
Employment status
#
| |||
Employed | 70.7 | 59.7 | 77.3 |
Not employed | 28.8 | 39.5 | 22.7 |
Missing/not stated
| 0.5 | 0.8 | |
Hospital sector (index child)
§
| |||
Private | 53.5 | 41.4 | |
Public3
| 43.6 | 57.8 | n.a. |
Other | 1.7 | 0.9 | |
Missing/not stated
| 1.2 | - |
Proportion of women who reported receiving perinatal mental health information and psychosocial assessment during the perinatal period
Outcome | Total | NSW | VIC | QLD | SA | WA | TAS | ACT | NT |
---|---|---|---|---|---|---|---|---|---|
N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | |
During pregnancy
| (N = 1804) | (N = 494) | (N = 501) | (N = 373) | (N = 143) | (N = 163) | (N = 56) | (N = 48) | (N = 16) |
Provision of PMH information | 1412 (78.3) | 391 (79.1) | 372 (74.3) | 289 (77.5) | 112 (78.3) | 132 (81.0) | 49 (87.5) | 46 (95.8)* | 13 (81.2)* |
Psychosocial assessment domain
| |||||||||
Current mental health | 1205 (66.8) | 350 (70.9) | 287 (57.3) | 240 (64.3) | 95 (66.4) | 131 (80.4) | 40 (71.4) | 41 (85.4) | 12 (75.0)* |
Mental health history | 954 (52.9) | 315 (63.8) | 217 (43.3) | 193 (51.7) | 74 (51.7) | 82 (50.3) | 29 (51.8) | 31 (64.6) | 8 (50.0) |
Level of support | 1261 (69.9) | 374 (75.7) | 332 (66.3) | 258 (69.2) | 103 (72.0) | 103 (63.2) | 37 (66.1) | 36 (75.0) | 11 (68.8) |
Drug and alcohol use | 1220 (67.6) | 355 (71.9) | 308 (61.5) | 258(69.2) | 99 (69.2) | 98 (60.1) | 40 (71.4) | 42 (87.5) | 13 (81.2)* |
Domestic violence or abuse | 644 (35.7) | 261 (52.8) | 110 (22.0) | 150 (40.2) | 54 (37.8) | 33 (20.2) | 12 (21.4) | 12 (25.0) | 7 (43.8) |
During postnatal period
§
| (N = 1442) | (N = 398) | (N = 394) | (N = 305) | (N = 114) | (N = 129) | (N = 44) | (N = 38) | (N = 14) |
Provision of PMH information | 1176 (81.6) | 322 (80.9) | 350 (88.8) | 210 (68.9) | 89 (78.1) | 118 (91.5) | 38 (86.4) | 32 (84.2) | 12 (85.7)* |
Psychosocial assessment domain
| |||||||||
Current mental health | 1090 (75.6) | 303 (76.1) | 331 (84.0) | 179 (58.7) | 75 (65.8) | 115 (89.1) | 39 (88.6) | 30 (78.9) | 12 (85.7) |
Mental health history | 594 (41.2) | 190 (47.7) | 144 (36.5) | 84 (27.5) | 58 (50.9) | 64 (49.6) | 23 (52.3) | 20 (52.6) | 8 (57.1) |
Level of support | 1011 (70.1) | 291 (73.1) | 298 (75.6) | 159 (52.1) | 85 (74.6) | 100 (77.5) | 34 (77.3) | 28 (73.7) | 11 (78.6) |
Drug and alcohol use | 509 (35.3) | 184 (46.2) | 115 (29.2) | 73 (23.9) | 52 (45.6) | 42 (32.6) | 19 (43.2) | 13 (34.2) | 8 (57.1) |
Domestic violence or abuse | 458 (31.8) | 185 (46.5) | 110 (27.9) | 58 (19.0) | 48 (42.1) | 27 (20.9) | 11 (25.0) | 12 (31.6) | 4 (28.6)** |
Factors associated with psychosocial assessment across the perinatal period
Given PMH information | Current emotional health | Mental health history | Level of support | Drug or alcohol use | Domestic violence or abuse | |
---|---|---|---|---|---|---|
N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | |
Pregnancy (N = 1804)
| ||||||
Partner status
| ||||||
Married/de facto | 1357 (78.2) | 1155 (66.6) | 910 (52.4) | 1207 (69.6) | 1174 (67.7) | 617 (35.6) |
Single1
| 50 (80.6) | 45 (72.6) | 40 (64.5) | 49 (79.0) | 42 (67.7) | 25 (40.3) |
Parity
| ||||||
Primiparous | 327 (82.8) | 258 (65.3) | 224 (56.7) | 268 (67.8) | 292 (73.9) | 137 (34.7) |
Multiparous | 1085 (77.0) | 947 (67.2) | 730 (51.8) | 993 (70.5) | 928 (65.9) | 507 (36) |
Income management
2
| ||||||
Not difficult | 594 (80.8) | 507 (69.0) | 413 (56.2) | 538 (73.2) | 519 (70.6) | 272 (37) |
Difficult | 812 (76.5) | 692 (65.2) | 537 (50.6) | 718 (67.7) | 697 (65.7) | 370 (34.9) |
Highest level of education
| ||||||
University degree or higher | 814 (75.7) | 673 (62.5) | 513 (47.7) | 716 (66.5) | 712 (66.2) | 331 (30.8) |
Year 12/Trade/ diploma | 521 (81.4) | 463 (72.3) | 379 (59.2) | 477 (74.5) | 446 (69.7) | 273 (42.7) |
Year 10 or below | 68 (88.3) | 60 (77.9) | 56 (72.7) | 61 (79.2) | 55 (71.4) | 37 (48.1) |
Area of residence
3
| ||||||
Urban | 806 (76.6) | 668 (63.5) | 521 (49.5) | 688 (65.4) | 672 (63.9) | 320 (30.4) |
Non-urban | 599 (80.6) | 528 (71.1) | 428 (57.6) | 565 (76.0) | 540 (72.7) | 317 (42.7) |
Background language
4
| ||||||
English | 1335 (79.1) | 1140 (67.5) | 908 (53.8) | 1197 (70.9) | 1159 (68.7) | 616 (36.5) |
Other | 67 (65.7) | 57 (55.9) | 42 (41.2) | 59 (57.8) | 56 (54.9) | 24 (23.5) |
Employment status
5
| ||||||
Employed | 1001 (78.4) | 833 (65.3) | 652 (51.1) | 880 (69.0) | 870 (68.2) | 442 (34.6) |
Not employed | 405 (78.0) | 366 (70.5) | 297 (57.2) | 376 (72.4) | 343 (66.1) | 200 (38.5) |
Maternity care sector
6
| ||||||
Private | 692 (71.7) | 542 (56.2) | 380 (39.4) | 550 (57.0) | 545 (56.5) | 177 (18.3) |
Public | 680 (86.4) | 622 (79) | 539 (68.5) | 666 (84.6) | 630 (80.1) | 443 (56.3) |
State/Territory of residence
7
| ||||||
NSW | 391 (79.1) | 350 (70.9) | 315 (63.8) | 374 (75.7) | 355 (71.9) | 261 (52.8) |
VIC | 372 (74.3) | 287 (57.3) | 217 (43.3) | 332 (66.3) | 308 (61.5) | 110 (22.0) |
QLD | 289 (77.5) | 240 (64.3) | 193 (51.7) | 258 (69.2) | 258 (69.2) | 150 (40.2) |
SA | 112 (78.3) | 95 (66.4) | 74 (51.7) | 103 (72.0) | 99 (69.2) | 54 (37.8) |
WA | 132 (81.0) | 131 (80.4) | 82 (50.3) | 103 (63.2) | 98 (60.1) | 33 (20.2) |
Other | 108 (90.0) | 93 (77.5) | 68 (56.7) | 84 (70.0) | 95 (79.2) | 31 (25.8) |
Postnatal period (N = 1442)
| ||||||
Partner status
| ||||||
Married/de facto | 1127 (81.7) | 1043 (75.6) | 567 (41.1) | 960 (69.6) | 488 (35.4) | 443 (32.1) |
Single1
| 47 (78.3) | 45 (75.0) | 26 (43.3) | 49 (81.7) | 21 (35.0) | 15 (25.0) |
Parity
| ||||||
Primiparous | 328 (87.7) | 294 (78.6) | 165 (44.1) | 277 (74.1) | 143 (38.2) | 128 (34.2) |
Multiparous | 848 (79.4) | 796 (74.5) | 429 (40.2) | 734 (68.7) | 366 (34.3) | 330 (30.9) |
Income management
2
| ||||||
Not difficult | 502 (82.8) | 456 (75.2) | 261 (43.1) | 422 (69.6) | 233 (38.4) | 194 (32.0) |
Difficult | 671 (80.7) | 630 (75.8) | 332 (40.0) | 587 (70.6) | 276 (33.2) | 264 (31.8) |
Highest level of education
| ||||||
University degree or higher | 689 (82.2) | 648 (77.3) | 331 (39.5) | 580 (69.2) | 282 (33.7) | 261 (31.1) |
Year 12/Trade/ diploma | 435 (81.2) | 397 (74.1) | 238 (44.4) | 384 (71.6) | 208 (38.8) | 179 (33.4) |
Year 10 or below | 48 (78.7) | 41 (67.2) | 24 (39.3) | 43 (70.5) | 19 (31.1) | 18 (29.5) |
Area of residence
3
| ||||||
Urban | 672 (82.3) | 616 (75.4) | 330 (40.4) | 571 (69.9) | 284 (34.8) | 259 (31.7) |
Non-urban | 499 (80.6) | 469 (75.8) | 261 (42.2) | 435 (70.3) | 222 (35.9) | 196 (31.7) |
Background language
4
| ||||||
English | 1105 (82.2) | 1026 (76.3) | 563 (41.9) | 953 (70.9) | 483 (35.9) | 437 (32.5) |
Other | 65 (74.7) | 58 (66.7) | 28 (32.2) | 54 (62.1) | 24 (27.6) | 20 (23.0) |
Employment status
5
| ||||||
Employed | 854 (82.7) | 794 (76.9) | 434 (42.0) | 725 (70.2) | 369 (35.7) | 336 (32.5) |
Not employed | 316 (78.8) | 291 (72.6) | 156 (38.9) | 281 (70.1) | 135 (33.7) | 119 (29.7) |
Maternity care sector
6
| ||||||
Private | 628 (82.7) | 576 (75.9) | 292 (38.5) | 518 (68.2) | 242 (31.9) | 216 (28.5) |
Public | 520 (80.7) | 487 (75.6) | 286 (44.4) | 466 (72.4) | 253 (39.3) | 231 (35.9) |
State/Territory of residence
7
| ||||||
NSW | 322 (80.9) | 303 (76.1) | 190 (47.7) | 291 (73.1) | 184 (46.2) | 185 (46.5) |
VIC | 350 (88.8) | 331 (84.0) | 144 (36.5) | 298 (75.6) | 115 (29.2) | 110 (27.9) |
QLD | 210 (68.9) | 179 (58.7) | 84 (27.5) | 159 (52.1) | 73 (23.9) | 58 (19.0) |
SA | 89 (78.1) | 75 (65.8) | 58 (50.9) | 85 (74.6) | 52 (45.6) | 48 (42.1) |
WA | 118 (91.5) | 115 (89.1) | 64 (49.6) | 100 (77.5) | 42 (32.6) | 27 (20.9) |
Other | 82 (85.4) | 81 (84.4) | 51 (53.1) | 73 (76.0) | 40 (41.7) | 27 (28.1) |
Given PMH information | Current emotional health | Mental health history | Level of support | Drug or alcohol use | Domestic violence or abuse | |
---|---|---|---|---|---|---|
PR§[95% CI] | PR§[95% CI] | PR§[95% CI] | PR§[95% CI] | PR§[95% CI] | PR§[95% CI] | |
Pregnancy (N = 1804)
| ||||||
Partner status
| ||||||
Married/de facto |
-
|
-
| 1 | 1 |
-
|
-
|
Single1
|
-
|
-
| 0.89 [0.73 , 1.03] | 1.04 [0.92 , 1.09] |
-
|
-
|
Parity
| ||||||
Primiparous |
1
|
-
|
1
|
1
|
-
| |
Multiparous |
0.94 [0.90 , 0.99]*
|
-
|
0.87 [0.80 , 0.95]*
|
0.91 [0.86 , 0.96]**
|
-
| |
Income management
2
| ||||||
Not difficult |
1
| 1 | 1 | 1 |
1
|
-
|
Difficult |
1.04 [1.00 , 1.09]*
| 1.02 [0.96 , 1.07] | 1.04 [0.96 , 1.13] | 1.03 [0.99 , 1.09] |
1.06 [1.01 , 1.12]*
|
-
|
Highest level of education
| ||||||
University degree or higher | - | 1 |
1
| 1 |
-
| 1 |
Year 12/Trade/ diploma | - | 1.06 [0.99 , 1.13] | 1.08 [0.99 , 1.17] | 1.04 [0.99 , 1.09] |
-
| 1.07 [0.97 , 1.18] |
Year 10 or below | - | 1.05 [0.92 , 1.14] |
1.24 [1.09 , 1.38]**
| 1.04 [0.93 , 1.13] |
-
| 1.12 [0.89 , 1.31] |
Area of residence
3
| ||||||
Urban | - |
1
| 1 | 1 | 1 | 1 |
Non-urban | - |
0.94 [0.90 , 1.00]*
| 0.96 [0.89 , 1.04] | 1.03 [0.99 , 1.09] | 0.99 [0.94 , 1.05] | 1.03 [0.93 , 1.14] |
Background language
4
| ||||||
English | 1 | 1 | 1 | 1 | 1 | |
Other | 0.89 [0.77 , 1.01] | 0.89 [0.74 , 1.01] | 0.87 [0.68 , 1.03] | 0.86 [0.71 , 1.00] | 0.79 [0.56 , 1.04] | |
Employment status
5
| ||||||
Employed |
-
| 1 | 1 |
-
|
-
| |
Not employed |
-
| 1.00 [0.94 , 1.06] | 1.03 [0.95 , 1.12] |
-
|
-
| |
Maternity care sector
6
| ||||||
Private |
1
|
1
|
1
|
1
|
1
|
1
|
Public |
1.19 [1.13 , 1.25]**
|
1.41 [1.31 , 1.51]**
|
1.72 [1.57 , 1.89]**
|
1.45 [1.36 , 1.55]**
|
1.39 [1.30 , 1.49]**
|
2.96 [2.56 , 3.45]**
|
#State/Territory of residence
7
| ||||||
NSW |
1
|
1
|
1
|
1
|
1
|
1
|
VIC | 0.95 [0.89 , 1.02] |
0.81 [0.74 , 0.88]
|
0.71 [0.63 , 0.79]
|
0.89 [0.83 , 0.95]
|
0.89 [0.82 , 0.96]
|
0.45 [0.38 , 0.53]
|
QLD | 1.01 [0.94 , 1.07] | 0.95 [0.87 , 1.04] |
0.86 [0.77 , 0.95]
|
0.94 [0.87 , 0.99]
| 1.00 [0.92 , 1.06] |
0.85 [0.75 , 0.95]
|
SA | 1.00 [0.91 , 1.09] | 0.92 [0.81 , 1.02] |
0.81 [0.69 , 0.93]
| 0.94 [0.85 , 1.02] | 0.94 [0.83 , 1.03] |
0.68 [0.55 , 0.82]
|
WA | 1.05 [0.96 , 1.12] |
1.12 [1.03 , 1.20]
|
0.82 [0.70 , 0.94]
|
0.85 [0.75 , 0.94]
|
0.87 [0.76 , 0.97]
|
0.42 [0.31 , 0.56]
|
Other |
1.08 [1.01 , 1.14]
|
1.12 [1.00 , 1.20]
| 0.91 [0.76 , 1.06] |
0.87 [0.76 , 0.96]
| 1.08 [0.99 , 1.14] |
0.48 [0.34 , 0.63]
|
Postnatal period (N = 1442)
| ||||||
Partner status
| ||||||
Married/de facto |
-
|
-
|
-
| 1 |
-
|
-
|
Single1
|
-
|
-
|
-
| 1.10 [0.94 , 1.22] |
-
|
-
|
Parity
| ||||||
Primiparous |
1
| 1 |
-
|
1
|
-
|
-
|
Multiparous |
0.92 [0.88 , 0.96]**
| 0.95 [0.90 , 1.01] |
-
|
0.93 [0.87 , 1.00]*
|
-
|
-
|
Income management
2
| ||||||
Not difficult | - |
-
|
-
|
-
| 1 |
-
|
Difficult | - |
-
|
-
|
-
| 1.15 [1.00 , 1.31] |
-
|
Background language
4
| ||||||
English | - |
1
| 1 | 1 |
-
|
1
|
Other | - |
0.85 [0.72 , 0.97]*
| 0.78 [0.56 , 1.03] |
0.83 [0.69 , 0.96]*
|
-
|
0.67 [0.44 , 0.95]*
|
Maternity care sector
6
| ||||||
Private | - |
-
| 1 | 1 | 1 | 1 |
Public | - |
-
| 1.09 [0.96 , 1.23] | 1.01 [0.94 , 1.08] | 1.14 [0.99 , 1.31] | 1.11 [0.96 , 1.29] |
#
State/Territory of residence
7
| ||||||
NSW |
1
|
1
|
1
|
1
|
1
|
1
|
VIC |
1.10 [1.04 , 1.17]
|
1.09 [1.02 , 1.17]
|
0.78 [0.66 , 0.92]
| 1.02 [0.94 , 1.11] |
0.65 [0.54 , 0.79]
|
0.62 [0.51 , 0.74]
|
QLD |
0.86 [0.78 , 0.94]
|
0.76 [0.68 , 0.85]
|
0.58 [0.47 , 0.72]
|
0.70 [0.62 , 0.79]
|
0.53 [0.42 , 0.66]
|
0.40 [0.31 , 0.52]
|
SA | 0.98 [0.87 , 1.08] |
0.85 [0.73 , 0.97]
| 1.06 [0.85 , 1.30] | 1.01 [0.88 , 1.13] | 0.98 [0.77 , 1.22] | 0.89 [0.69 , 1.12] |
WA |
1.13 [1.06 , 1.21]
|
1.15 [1.06 , 1.24]
| 1.04 [0.84 , 1.27] | 1.04 [0.93 , 1.16] |
0.71 [0.54 , 0.92]
|
0.45 [0.31 , 0.63]
|
Other | 1.05 [0.95 , 1.15] | 1.10 [0.98 , 1.20] | 1.08 [0.85 , 1.33] | 1.02 [0.88 , 1.15] | 0.88 [0.66 , 1.13] |
0.57 [0.39 , 0.79]
|