Perinatal mental health: The role of social inequalities and domestic abuse on maternal outcomes
Categories: Research using linked data, ADR Northern Ireland, Health & wellbeing
17 January 2025
This project, led by researchers at ADR Northern Ireland, investigates how social inequalities and domestic abuse affect the health and survival of mothers with mental health conditions during pregnancy and after childbirth in Northern Ireland.
Perinatal mental health conditions, including depression, anxiety disorders, postpartum psychosis, and bipolar disorder, occur during pregnancy or within the first year of giving birth. They affect up to 27% of new and expectant mothers and are a leading cause of maternal death during and after pregnancy, with long term consequences for mothers, babies, and families.
There is little research on how these conditions, combined with wider adversities like social inequalities, socio-demographic factors, mothers’ interactions with social services when they were children, and domestic abuse, affect mothers’ health and survival outcomes.
Aims and key questions
The aim of this project is to assess how wider adversities affect the health and survival of mothers with perinatal mental health conditions in Northern Ireland.
The project will:
- Assess the sociodemographic and socioeconomic factors contributing to perinatal mental health conditions, and the impact of these on mothers’ health and survival outcomes (e.g. higher mental health medication use and/or hospital admissions)
- Investigate if domestic abuse is associated with the health and survival outcomes of mothers with perinatal mental health conditions
- Evaluate the relationship between mothers’ interactions with social services in childhood and the health and survival outcomes of mothers with perinatal mental health conditions
- Explore the extent to which wider adversities (i.e. socioeconomic inequalities, socio-demographic factors, interactions with social services in childhood, and domestic abuse) contribute to the health and survival outcomes of mothers with perinatal mental health conditions
- Evaluate if the mother’s health status during the perinatal period is an indicator of their future mental health status.
About the data
This population-based cross-sectional study will analyse secondary data held in the Honest Broker Service, the trusted research environment for Health and Social Care services in Northern Ireland.
All mothers giving birth in Northern Ireland between 1 January 2010 and 31 December 2021 will be included in the study. The data extract will include data up to 31 December 2022, to capture information on the first year after birth for mothers giving birth in 2021. If a woman has more than one pregnancy during the study period, each pregnancy will be included.
Anonymised data from the following datasets will be analysed:
- Northern Ireland Maternity System) (NIMATS): demographic and clinical information on mothers and infants, including variables on domestic abuse.
- Enhanced Prescribing Dataset: data on prescriptions.
- Registrar General: vital events data, such as on births and deaths.
- Patient Administration Systems (PAS): patient information, including hospital episodes and admissions/discharges.
- Northern Ireland Regional Accident & Emergency System and Symphony (A&E): emergency department data.
- Mental health inpatient data (2010-2016): data on mental health episodes.
- Social Services Care Administrative and Records Environment (1985-2022): social services data.
- Land & Property Services: socioeconomic data.
Data for the years 2010-2022 will be extracted from these datasets and will be linked by the Honest Broker Service using the mother’s Health and Social Care number (recorded in NIMATS), or their hospital number (recorded in PAS) if this is not available.
Potential
This will be the first study to investigate the effects of wider adversities on the health and survival outcomes of mothers with perinatal mental health conditions. In particular, the impact of domestic abuse and interactions with social services in childhood has not yet been assessed in this population.
By analysing mothers’ mental health status as an indicator of future mental health status, we can identify “at risk” individuals earlier and develop targeted, appropriate support and interventions. This has clear benefits for affected mothers, their healthcare providers, and policymakers.
Project details
Lead: Dr Maria Loane
Research team: Dr Maria Loane, Dr Joanne Given, Dr Michael Rosato, Prof Gerry Leavey
Duration: Due to be completed by March 2026.
Contact: Administrative Data Research Centre Northern Ireland office.
Funding: This project is funded by ADRC NI via its core grant from the Economic & Social Research Council (ESRC) via ADR UK.
Categories: Research using linked data, ADR Northern Ireland, Health & wellbeing