Two Thirds of Pregnant Women Under 25 in London Have a Mental Health Problem

Summary: According to a new study, 67% of pregnant women under the age of 25 in London suffer from mental health disorders, such as depression, anxiety and PTSD. Based on the findings, researchers suggest more could be done to target prenatal mental health services for younger women.

Source: National Institute for Health Research.

New research suggests two-thirds (67%) of pregnant women in London aged between 16 and 24 years have mental health problems including depression, anxiety disorders, post-traumatic stress disorder and obsessive compulsive disorder, according to new research funded by the National Institute for Health Research (NIHR). Anxiety disorders, in particular social phobia, are especially high.

By comparison, the research suggests roughly one in five (21%) pregnant women in London aged 25 years and over have mental health problems.

Researchers from Institute of Psychiatry, Psychology & Neuroscience at King’s College London recruited 575 women through their first antenatal appointment with an inner-city London maternity service. Of this group, 57 women were aged between 16 and 24.

All women were interviewed using a psychiatric gold standard diagnostic interview to determine if they met the criteria for one or more mental health condition. The researchers also recorded information about their socio-demographic background, such as ethnicity, educational level and employment status.

According to the research, published in BJPsych Open, pregnant women under 25 were also more likely to be non-white, single, living in poverty, homeless or living in emergency accommodation, unemployed, or have an unplanned pregnancy.

The rate of lifetime abuse was high (38.9%), with rates of sexual abuse at 20.6% and partner abuse at 19.5%. The researchers note that this is probably an under-estimate, as abuse is often under-reported. Experience of abuse and living alone were both risk factors for mental health problems in this group.

Lead author Dr Georgia Lockwood Estrin, Senior Research Associate at King’s College London, said: “We’ve shown a shockingly high prevalence of mental disorders in young pregnant women aged 16 to 24 years in London compared with women aged 25 years or older. We found that, in comparison to previous research has focused primarily on postnatal depression, young women experience a broad range of mental disorders during early pregnancy, with anxiety disorders being particularly prevalent.”

The researchers particularly highlight that the high risk for mental disorders is not limited to pregnant teenagers, as may have been suggested by previous research, but remains high for women in their early 20s.

The research suggests that more could be done to target perinatal mental health services at women aged under 25. This aligns with the recent NHS Long Term Plan and NHS Five Year Plan* to ensure that by 2023/24 at least 54,000 more women each year can access evidence-based specialist mental health care during the perinatal period.

Prof Louise Howard, senior author on the paper and NIHR Research Professor in maternal mental health at King’s College London, said: “We were alarmed to see such high rates of mental illness in pregnant women under 25. The recent National Well-Being Survey and other studies have highlighted that around one in four women under 25 have self-harmed and/or have mental illness, higher than in previous surveys, but our study suggests that pregnant women under 25 are at even higher risk of mental disorders.

“This study needs to be repeated as it is based on relatively small numbers of women in a particular area of London, but our findings highlight the need for maternity services to ensure pregnant women under 25 are comprehensively assessed for mental health problems and domestic or sexual abuse so they can receive appropriate treatment and help.”

About this neuroscience research article

Funding: The study was supported by the National Institute for Health Research.
Source: Shane Canning – National Institute for Health Research
Publisher: Organized by NeuroscienceNews.com.
Image Source: The image is in the public domain.
Original Research: The Young pregnant women and risk for mental disorders: findings from an early pregnancy cohort appears in BJPsych Open.
doi: 10.1192/bjo.2019.6

Lockwood Estrin, G., Ryan, E., Trevillion, K., Demilew, J., Bick, D., Pickles, A., & Howard, L. (2019). Young pregnant women and risk for mental disorders: Findings from an early pregnancy cohort. BJPsych Open, 5(2), E21. doi:10.1192/bjo.2019.6

Abstract:

Background
Young women aged 16–24 are at high risk of common mental disorders (CMDs), but the risk during pregnancy is unclear.

Aims
To compare the population prevalence of CMDs in pregnant women aged 16–24 with pregnant women ≥25 years in a representative cohort, hypothesising that younger women are at higher risk of CMDs (depression, anxiety disorders, post-traumatic stress disorder, obsessive–compulsive disorder), and that this is associated with low social support, higher rates of lifetime abuse and unemployment.

Method
Analysis of cross-sectional baseline data from a cohort of 545 women (of whom 57 were aged 16–24 years), attending a South London maternity service, with recruitment stratified by endorsement of questions on low mood, interviewed with the Structured Clinical Interview DSM-IV-TR.

Results
Population prevalence estimates of CMDs were 45.1% (95% CI 23.5–68.7) in young women and 15.5% (95% CI 12.0–19.8) in women ≥25, and for ‘any mental disorder’ 67.2% (95% CI 41.7–85.4) and 21.2% (95% CI 17.0–26.1), respectively. Young women had greater odds of having a CMD (adjusted odds ratio (aOR) = 5.8, 95% CI 1.8–18.6) and CMDs were associated with living alone (aOR = 3.0, 95% CI 1.1–8.0) and abuse (aOR = 1.5, 95% CI 0.8–2.8).

Conclusions
Pregnant women between 16 and 24 years are at very high risk of mental disorders; services need to target resources for pregnant women under 25, including those in their early 20s. Interventions enhancing social networks, addressing abuse and providing adequate mental health treatment may minimise adverse outcomes for young women and their children.

Declaration of interest
None.

Image shows a pregnant woman.

The researchers particularly highlight that the high risk for mental disorders is not limited to pregnant teenagers, as may have been suggested by previous research, but remains high for women in their early 20s.

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