Inpatient mother-and-child postpartum psychiatric care: factors associated with improvement in maternal mental health.

International audiencePURPOSE: This study assessed the underexplored factors associated with significant improvement in mothers' mental health during postpartum inpatient psychiatric care. METHODS: This study analyzed clinical improvement in a prospective cohort of 869 women jointly admitted with their infant to 13 psychiatric Mother-Baby Units (MBUs) in France between 2001 and 2007. Predictive variables tested were: maternal mental illness (ICD-10), sociodemographic characteristics, mental illness and childhood abuse history, acute or chronic disorder, pregnancy and birth data, characteristics and mental health of the mother's partner, and MBU characteristics. RESULTS: Two thirds of the women improved significantly by discharge. Admission for 25% was for a first acute episode very early after childbirth. Independent factors associated with marked improvement at discharge were bipolar or depressive disorder, a first acute episode or relapse of such an episode. Schizophrenia, a personality disorder, and poor social integration (as measured by occupational status) were all related to poor clinical outcomes. DISCUSSION: Most women improved significantly while under care in MBUs. Our results emphasize the importance of the type of disease but also its chronicity and the social integration when providing postpartum psychiatric care

Accompagnement vers une autre grossesse après infanticide

Objectif : décrire l’évolution des grossesses suivant un infanticide avec et sans déni de grossesse. Méthode : présentation de deux situations cliniques de mères inculpées d’infanticide. Résultats : l’évolution favorable d’une grossesse survenant après un infanticide est illustrée par le matériel clinique. Plusieurs aménagements de la prise en charge qui permettent de renforcer le lien mère-nourrisson sont discutés