Do refugee women have increased risk of perinatal psychiatric dirsorders: a registered-based study?

Abstract

Abstract Perinatal mental health (PMD) disorders affect up to 15% of women and have negative, long-lasting impact on mothers and children. This is recognized by the WHO as major public health issue. Studies show that migrant women are at increased risk of experiencing perinatal depression and anxiety compared to non-migrants. Knowledge about risk of other mental health disorders is limited and studies in Europe have not examined differences among women with different migrant status. This registered based study examines whether refugee (R) women and different groups of family-reunified (FR) migrants in Denmark have higher risk of PMD compared to native Danes (D) and, how migration related factors are associated with differences in risk of PMD among migrants. We use data from the Danish Adult Refugee Cohort, which includes all refugee and family-reunified individuals who received residence permission in Denmark from 1998-2014 matched 1:6 to Danish born (D) individuals. We identified 274,920 women that gave birth to a live child, without prior psychiatric history and compared risk for PMD from pregnancy to 1 years postpartum between R, FR to R, FR to migrants, FR to Danes, and D women. Differences in types of diagnose (affective, psychotic, neurotic, or any other psychiatric disorder) were examined in sub-analyses. Within migrant women, we examined differences in psychiatric contact by region of origin, time since migration, refugee status, sociodemographic, and birth characteristics. Compared to Danish born women, refugee women were more likely to have a PMD (aOR 1.23, 95% CI 1.01-1.49) and a higher burden of psychotic and neurotic-stress related disorders, while FR to migrants were less likely to have a PMD (aOR=0.37, 95% CI; 0.22-0.64) adjusting covariates. No differences in PMD emerged between FR to refugees, FR to Danes and Danes. Findings will have implications for perinatal mental health service delivery targeting certain immigrant groups and particularly refugees. Key messages Refugee women are at increased risk of experiencing psychiatric disorders during the perinatal period and efforts should be made to offer psychosocial support during pregnancy and after birth. Certain groups of non-refugee migrants may benefit from a ‘healthy migrant effect’ in regards to their risk of experiencing psychiatric disorders during the perinatal period.