HIGHLIGHTS ON MATERNAL MENTAL HEATH DISORDERS IN A TERTIARY EMARTI HOSPITAL

Authors and Affiliations: Dr Shahad Mahmoud Hussein (presenting) ^1,2, Dr Afraa Jamal AlYoussef ¹, Dr Rubina Rashid Shaikh ¹, Dr Fatima Salman ², Dr Abdul Rahman Taha ², Dr Tariq Saadaldin Altamimi ², Dr Walaa Abdul Rahman Alsafi¹, Dr Muhieddine Abdul Fatah Seoud ^1,2

1 Shaikh Shakhbout Medical City, Abu Dhabi, UAE, 2 Khalifa University, Abu Dhabi, UAE

Objective: To report on a 3-years prevalence of diagnosed perinatal Maternal Mental Health Disorders (MMHD), of women who delivered in a tertiary care center in Abu Dhabi, United Arab Emirates (UAE). 

Design: Hospital based retrospective descriptive study

Method: Data were collected from electronic medical records of patients diagnosed with MMHD, who delivered in our hospital,10-01-2020 to 10-01-2023. Study variables were; demographic characteristics, types of MMHD, medications, presence of suicidal ideas/attempts, gestation at presentation, and pregnancy outcomes. Data were entered on an Excel Sheet, and results presented numerically and in percentages.

Results:  27 cases of MMHD delivered in our centre, out of 6218 deliveries in the study period. Prevalence of MMHD was found to be low, less than 1%. Maternal age ranged mostly between 21-40 years (N=21, 77.74%), more than half (N= 18, 66.67%) were overweight, majority unemployed (N=18, 66.67%), 5 employed; 2 nurses, 2 office workers, 1 teacher, and 4 unknown. Most presented at 20-42 weeks of gestation (N=24, 88.89%), 2 below 20 weeks (7.40%), and least postpartum (N=1, 3.70%). More than half had Mood Disorders (N=16, 59.23%); 13 of which had Unipolar or Depressive Disorders, while 3 had Bipolar Disorders, 5 had Perinatal Anxiety Disorders (18.52 %), 4 had Psychotic Disorders (14.81%); 3 postpartum psychosis and 1 Schizoaffective. Other cases included Adjustment Disorders (N=3,11.11%), 2 Obsessive Compulsive, 2 Conversion Disorders (7.40% each), 1 Panic Attack, 1 Social Phobia, 1 Dissociative Disorder (3.7% each) and 3 (11.11%) had multiple disorders. A quarter were on anti-psychotics (N= 7, 25.93%), 6 on Selective-Receptor-Inhibitors (SSRIs) (22.22%), 4 on benzodiazepines (14.81%), and the rest non-compliant (N=6, 22.22%). A quarter had suicidal ideas/attempts (N=7, 25.93 %), 5 of 7 attempted suicide; the rest had suicidal ideas, 4 (14.81%) reported domestic abuse, 3 (11.11%) had no family support, 3 (11.11%) no financial support, 1 was under police custody, 1 reported drug addiction, and 1 smoking. 9 (33.33%) delivered by caesarean section, 5 babies were low birth weight (18.5%), none macrosomic, and the majority breast fed (N=17, 62.96%)

Conclusions: The prevalence of MMHD is alarmingly under estimated. Despite our small study sample, women identified with suicidal ideas/attempts highlighted an urgent need for action. We developed a multidisciplinary guideline including psychologists and psychiatrists to screen for MMHD, identify vulnerable women, timely triage to psychologist/psychiatrist, and provide joint care before, during and after pregnancies. Future auditing and research will highlight further areas for quality improvement.