{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T15:37:39Z","timestamp":1790177859423,"version":"4.1.0"},"reference-count":22,"publisher":"Royal College of Psychiatrists","issue":"3","license":[{"start":{"date-parts":[[2018,6,21]],"date-time":"2018-06-21T00:00:00Z","timestamp":1529539200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec id=\"S0007125018000922_sec_a1\"><jats:title>Background<\/jats:title><jats:p>Pregnancy and childbirth are a period of high risk for women with bipolar disorder and involve difficult decisions particularly about continuing or stopping medications.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125018000922_sec_a2\"><jats:title>Aims<\/jats:title><jats:p>To explore what clinical predictors may help to individualise the risk of perinatal recurrence in women with bipolar disorder.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125018000922_sec_a3\" sec-type=\"methods\"><jats:title>Method<\/jats:title><jats:p>Information was gathered retrospectively by semi-structured interview, questionnaires and case-note review from 887 women with bipolar disorder who have had children. Clinical predictors were selected using backwards stepwise logistic regression, conditional permutation random forests and reinforcement learning trees.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125018000922_sec_a4\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Previous perinatal history of affective psychosis or depression was the most significant predictor of a perinatal recurrence (odds ratio (OR) = 8.5, 95% CI 5.04\u201314.82 and OR = 3.6, 95% CI 2.55\u20135.07 respectively) but even parous women with bipolar disorder without a previous perinatal mood episode were at risk following a subsequent pregnancy, with 7% developing postpartum psychosis.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125018000922_sec_a5\" sec-type=\"conclusion\"><jats:title>Conclusions<\/jats:title><jats:p>Previous perinatal history of affective psychosis or depression is the most important predictor of perinatal recurrence in women with bipolar disorder and can be used to individualise risk assessments.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125018000922_sec_a6\"><jats:title>Declaration of interest<\/jats:title><jats:p>None.<\/jats:p><\/jats:sec>","DOI":"10.1192\/bjp.2018.92","type":"journal-article","created":{"date-parts":[[2018,6,25]],"date-time":"2018-06-25T01:27:28Z","timestamp":1529890048000},"page":"542-547","source":"Crossref","is-referenced-by-count":67,"title":["Stratification of the risk of bipolar disorder recurrences in pregnancy and postpartum"],"prefix":"10.1192","volume":"213","author":[{"given":"Arianna","family":"Di Florio","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Gordon-Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liz","family":"Forty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael 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