An examination of the association between marital status and prenatal mental disorders using linked health administrative data

Abstract

Abstract Background International research shows marital status impacts the mental health of pregnant women, with prenatal depression and anxiety being higher among non-partnered women. However, there have been few studies examining the relationship between marital status and prenatal mental disorders among Australian women. Methods This is a population-based retrospective cohort study using linked data from the New South Wales (NSW) Perinatal Data Collection (PDC) and Admitted Patients Data Collection (APDC). The cohort consists of a total of 598,599 pregnant women with 865,349 admissions. Identification of pregnant women for mental disorders was conducted using the 10th version International Classification of Diseases and Related Health Problems, Australian Modification (ICD-10-AM). A binary logistic regression model was used to estimate the relationship between marital status and prenatal mental disorder after adjusting for confounders. Results Of the included pregnant women, 241 (0.04%), 107 (0.02%) and 4359 (0.5%) were diagnosed with depressive disorder, anxiety disorder, and self-harm, respectively. Non-partnered pregnant women had a higher likelihood of depressive disorder (Adjusted Odds Ratio (AOR) = 2.75; 95% CI: 2.04, 3.70) and anxiety disorder (AOR = 3.16, 95% CI: 2.03, 4.91), compared with partnered women. Furthermore, the likelihood of experiencing self-harm was two times higher among non-partnered pregnant women (AOR = 2.00; 95% CI: 1.82, 2.20) than partnered pregnant women. Conclusions Non-partnered marital status has a significant positive association with prenatal depressive disorder, anxiety disorder and self-harm. This suggests it would be highly beneficial for maternal health care professionals to screen non-partnered pregnant women for prenatal mental health problems such as depression, anxiety and self-harm.