Smith, Holly Christina;
(2023)
Epidemiology of postnatal care and antidepressant
treatment in postpartum women:
Evidence from Primary Care Electronic Health Records.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
Background: Childbirth is a common event, but little is known about how women use primary care services after childbirth. The aims of this thesis were to understand the primary care use of women in the year after childbirth and to determine the duration of antidepressant treatment in women with postnatal depression. // Methods: Two studies utilised information from UK primary care Electronic Health Records (IQVIA Medical Research Database (IMRD)) to estimate prevalence of postnatal checks, primary care consultation rates and determine the most common health needs and treatments prescribed to women in first year after childbirth. Two further studies, a systematic review and a cohort study using IMRD, investigated the duration of antidepressant treatment in women with postnatal depression. // Findings: The first two studies demonstrated that women consult on average 4.8 times per year and that most women (95%) had at least one consultation in the year after childbirth. The most common reasons for consulting were for a postnatal visit or check, for monitoring (e.g blood pressure reading), and to access contraception. Only half of women (56%) had a record of a postnatal check, and younger and more deprived women were less likely to have this check. Part two of this thesis found that 13% of women initiated antidepressant treatment in the year after childbirth, with a median treatment duration of 6.5 months. Younger and more deprived women were more likely to have a postnatal antidepressant prescription but shorter treatment duration. Most notably, women with an antidepressant prescription during pregnancy were seven times more likely to have a postnatal prescription and longer treatment duration (9.6 vs 5.5 months). // Conclusions: Work from this thesis provides a valuable baseline from which to evaluate more recent postnatal care policy changes and steps to expand the current provision of primary care support for women after childbirth should be consider.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Epidemiology of postnatal care and antidepressant treatment in postpartum women: Evidence from Primary Care Electronic Health Records |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | CC BY-NC: Copyright © The Author 2023. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10179382 |
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