{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:23:19Z","timestamp":1790655799516,"version":"4.1.0"},"reference-count":28,"publisher":"Royal College of Psychiatrists","issue":"3","license":[{"start":{"date-parts":[[2023,6,21]],"date-time":"2023-06-21T00:00:00Z","timestamp":1687305600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["CIHR PCG-155466"],"award-info":[{"award-number":["CIHR PCG-155466"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec id=\"S0007125023000740_sec_a1\"><jats:title>Background<\/jats:title><jats:p>Common postpartum mental health (PMH) disorders such as depression and anxiety are preventable, but determining individual-level risk is difficult.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125023000740_sec_a2\"><jats:title>Aims<\/jats:title><jats:p>To create and internally validate a clinical risk index for common PMH disorders.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125023000740_sec_a3\" sec-type=\"methods\"><jats:title>Method<\/jats:title><jats:p>Using population-based health administrative data in Ontario, Canada, comprising sociodemographic, clinical and health service variables easily collectible from hospital birth records, we developed and internally validated a predictive model for common PMH disorders and converted the final model into a risk index. We developed the model in 75% of the cohort (<jats:italic>n<\/jats:italic> = 152 362), validating it in the remaining 25% (<jats:italic>n<\/jats:italic> = 75 772).<\/jats:p><\/jats:sec><jats:sec id=\"S0007125023000740_sec_a4\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>The 1-year prevalence of common PMH disorders was 6.0%. Independently associated variables (forming the mnemonic PMH CAREPLAN) that made up the risk index were: (P) prenatal care provider; (M) mental health diagnosis history and medications during pregnancy; (H) psychiatric hospital admissions or emergency department visits; (C) conception type and complications; (A) apprehension of newborn by child services (newborn taken into care); (R) region of maternal origin; (E) extremes of gestational age at birth; (P) primary maternal language; (L) lactation intention; (A) maternal age; (N) number of prenatal visits. In the index (scored 0\u201339), 1-year common PMH disorder risk ranged from 1.5 to 40.5%. Discrimination (C-statistic) was 0.69 in development and validation samples; the 95% confidence interval of expected risk encompassed observed risk for all scores in development and validation samples, indicating adequate risk index calibration.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125023000740_sec_a5\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>Individual-level risk of developing a common postpartum mental health disorder can be estimated with data feasibly collectable from birth records. Next steps are external validation and evaluation of various cut-off scores for their utility in guiding postpartum individuals to interventions that reduce their risk of illness.<\/jats:p><\/jats:sec>","DOI":"10.1192\/bjp.2023.74","type":"journal-article","created":{"date-parts":[[2023,6,21]],"date-time":"2023-06-21T09:29:00Z","timestamp":1687339740000},"page":"422-429","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":4,"title":["Clinical index to quantify the 1-year risk for common postpartum mental disorders at the time of delivery (PMH CAREPLAN): development and internal validation"],"prefix":"10.1192","volume":"223","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2736-9639","authenticated-orcid":false,"given":"Simone N.","family":"Vigod","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Urbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Calzavara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0135-7242","authenticated-orcid":false,"given":"Cindy-Lee","family":"Dennis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Gruneir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5644-8432","authenticated-orcid":false,"given":"Brett D.","family":"Thombs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Walker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8690-5841","authenticated-orcid":false,"given":"Hilary K.","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2023,6,21]]},"reference":[{"key":"S0007125023000740_ref13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2000.tb11609.x"},{"key":"S0007125023000740_ref8","doi-asserted-by":"publisher","DOI":"10.1002\/sim.6994"},{"key":"S0007125023000740_ref24","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-536X.2003.00228.x"},{"key":"S0007125023000740_ref7","doi-asserted-by":"publisher","DOI":"10.3803\/EnM.2016.31.1.38"},{"key":"S0007125023000740_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32640-5"},{"key":"S0007125023000740_ref25","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-019-1094-5"},{"key":"S0007125023000740_ref26","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000368"},{"key":"S0007125023000740_ref27","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/530769"},{"key":"S0007125023000740_ref18","volume-title":"The Power of Database Linkage: A New Source of Longitudinal Maternal\u2013Child Data is BORN","author":"Fell","year":"2015"},{"key":"S0007125023000740_ref28","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61278-2"},{"key":"S0007125023000740_ref9","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-010-1464-2"},{"key":"S0007125023000740_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61276-9"},{"key":"S0007125023000740_ref11","doi-asserted-by":"publisher","DOI":"10.1080\/13697137.2021.1945027"},{"key":"S0007125023000740_ref21","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(20000229)19:4<453::AID-SIM350>3.0.CO;2-5"},{"key":"S0007125023000740_ref4","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31821187a7"},{"key":"S0007125023000740_ref16","first-page":"339","volume-title":"Patterns of Health Care in Ontario The ICES Practice Atlas","author":"Williams","year":"1996"},{"key":"S0007125023000740_ref3","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291717000617"},{"key":"S0007125023000740_ref10","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1742"},{"key":"S0007125023000740_ref15","unstructured":"15 Juurlink, DPC , Croxford, R , Chong, A , Austin, P , Tu, J , Laupacis, A . 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