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Meta-Analysis
. 2022 Jul 13;83(5):21r14045.
doi: 10.4088/JCP.21r14045.

Prevalence of Bipolar Disorder in Perinatal Women: A Systematic Review and Meta-Analysis

Grace A Masters  1   2 , Julie Hugunin  1 , Lulu Xu  1 , Christine M Ulbricht  1   3 , Tiffany A Moore Simas  1 , Jean Y Ko  4   5 , Nancy Byatt  1
Affiliations
Meta-Analysis

Prevalence of Bipolar Disorder in Perinatal Women: A Systematic Review and Meta-Analysis

Grace A Masters et al. J Clin Psychiatry. .

Abstract

Objective: To estimate overall prevalence of bipolar disorder (BD) and the prevalence and timing of bipolar-spectrum mood episodes in perinatal women.

Data Sources: Databases (PubMed, Scopus, PsycINFO, CINAHL, Cochrane, ClincalTrials.gov) were searched from inception to March 2020.

Study Selection: Included studies were original research in English that had (1) populations of perinatal participants (pregnant or within 12 months postpartum), aged ≥ 18 years, and (2) a screening/diagnostic tool for BD. Search terms described the population (eg, perinatal), illness (eg, bipolar disorder), and detection (eg, screen, identify).

Data Extraction: Study design data, rates, and timing of positive screens/diagnoses and mood episodes were extracted by 3 independent reviewers. Pooled prevalences were estimated using random-effects meta-analyses.

Results: Twenty-two articles were included in qualitative review and 12 in the meta-analysis. In women with no known psychiatric illness preceding the perinatal period, pooled prevalence of BD was 2.6% (95% CI, 1.2%-4.5%) and prevalence of bipolar-spectrum mood episodes (including depressed, hypomanic/manic, mixed) during pregnancy and the postpartum period was 20.1% (95% CI, 16.0%-24.5%). In women with a prior BD diagnosis, 54.9% (95% CI, 39.2%-70.2%) were found to have at least one bipolar-spectrum mood episode occurrence in the perinatal period.

Conclusions: Our review suggests that the perinatal period is associated with high rates of bipolar-spectrum mood episodes and that pregnant and postpartum women represent a special risk population. This review may help to inform clinical care recommendations, thus helping to identify those who may have.

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Conflict of interest statement

Relevant financial relationships: Dr Moore Simas is a consultant as the Obstetric Engagement Liaison for MCPAP for Moms and as such has received a stipend from the Massachusetts Department of Mental Health via Beacon Health Options. She has served on ad hoc advisory boards and as a speaker for Sage Therapeutics, was a consultant for Sage Therapeutics and Ovia, and has received honoraria from Miller Medical Communications. Dr Moore Simas is the co-chair of the American College of Obstetricians and Gynecologists’ Maternal Mental Health Expert Work Group. Dr Byatt is the statewide Medical Director of the Massachusetts Child Psychiatry Access Program (MCPAP) for Moms and thus has received salary and/or funding support from Massachusetts Department of Mental Health. She has served on ad hoc advisory boards and as a speaker for Sage Therapeutics, was a consultant for Sage Therapeutics and Ovia Health, and has received honoraria from Miller Medical Communications, WebMD/Medscape, and Mathematica. Dr Byatt is also a member of the American College of Obstetricians and Gynecologists’ Maternal Mental Health Expert Work Group. Ms Masters, Ms Hugunin, Dr Xu, Dr Ulbricht, and Dr Ko have no conflicts of interest to report.

Figures

Figure 1.
Figure 1.. Forest Plots Demonstrating Estimates of the Overall Prevalence of Bipolar Disorder in Women Without Known Psychiatric Illness Preceding the Perinatal Period
aForest plot of studies included in pooled prevalence calculations (P = .00). Heterogeneity score (I2) was found to be 92%. bForest plot of studies that used the Mood Disorder Questionnaire to estimate rates of BD and pooled prevalence estimate (P = .00). Heterogeneity score (I2) was 78%. cForest plot of studies that used a diagnostic interview to estimate rates of BD and pooled prevalence estimate (P = .00). Heterogeneity score (I2) was 90%.
Figure 2.
Figure 2.. Forest Plots Demonstrating Estimates of the Occurrence of Bipolar-Spectrum Mood Episodes in the Perinatal Period
aForest plot of BD and pooled prevalence estimate (P = .00). Heterogeneity score (I2) was 91%. bForest plot of BD and pooled prevalence estimate (P = .00). Heterogeneity score (I2) was 89%.
See this image and copyright information in PMC

Comment in

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