Queen's University Belfast

Academic Institute

Ciaran Mulholland

E022

The Northern Ireland Maternity System (Northern Ireland Regional Maternity system (NIMATS)) is a regional electronic data recording system used by midwives to record information about all women who present to maternity services in Northern Ireland. It was first introduced in the 1980s to gather data on all women presenting to maternity services across the region. At various points in a woman’s pregnancy midwives obtain information about the woman’s demographic profile, their current health, Admissions and Dischargest medical/ obstetric and psychiatric history and family history. Much of the data is recorded at the booking appointment when the woman first attends maternity services, but some is also recorded at the point of admission to and discharge from the maternity ward (for example, information about the birth itself such as the mode of delivery). Over the Admissions and Dischargest approximately five years, women have routinely been asked about a personal or family history of several severe mental disorders including schizophrenia, bipolar disorder, severe obsessive compulsive disorder, eating disorder, depression and postnatal psychosis. This study aims to obtain data from the Northern Ireland Regional Maternity system (NIMATS) database related to such disorders in order to inform service provision in Northern Ireland. In the first instance this would include simply obtaining accurate figures for the number of women each year who report a history of these disorders. Other proposed analyses would include examining the data to determine if a history of severe mental illness is statistically associated with pregnancy outcomes, or other socio-demographic or clinical variables.

Mental disorders represent a leading cause of morbidity and mortality amongst women in the perinatal period. This has been highlighted in the Confidential Enquiries into Maternal Deaths and Morbidity. For example, in the UK and Ireland in the period 2009 – 2013 there were 3.7 deaths per 100 000 maternities from mental health-related causes during or up to one year after the end of pregnancy (95% confidence interval [95% CI] 3.2 – 4.4) [1]. Unfortunately service provision for perinatal mental health is variable across the UK and Ireland [2]. In particular, in Northern Ireland there is no dedicated regional perinatal mental health service, and the region does not have a mother and baby unit despite clear commissioning recommendations to the contrary [3]. A recent regional audit contributed evidence for this disparity: over a period of 32 weeks, the audit identified 75 women who were admitted to acute psychiatric care facilities (general acute inpatient wards or home treatment teams) who, in other regions of the UK with appropriate services, would meet criteria for admission to a specialist mother and baby unit [4]. It is clear, therefore, that accurate and up-to-date statistics concerning the prevalence of such disorders in this population are sorely needed.

02/03/2017

TRE