ABSTRACT
New-onset psychiatric disease in pregnancy ....................... 277
Understanding the pathophysiology of postpartum
affective disorders ........................................................................ 280
Overall, the incidence of mild mental health problems is not signifi cantly different during pregnancy, although the risk
of developing an antepartum serious new-onset psychiatric disorder is reduced. However, the risk of bipolar or severe
depressive illness is greatly increased postpartum. Women with previous serious mental health problems are at high risk
of a recurrence during both the antepartum and postpartum periods. It is vital for all healthcare professionals providing
maternity and psychiatric care to understand how pregnancy may interact with mental health and to understand key themes
in the detection of those at risk, and their subsequent management during and after the pregnancy. A multidisciplinary
approach, supervised by specialist perinatal mental health teams, is vital to optimize care, limit morbidity and help prevent
the tragic cases detailed in the maternal mortality reports. The problems of substance and alcohol misuse during pregnancy
overlap signifi cantly with mental health issues, and coordination is required between specialist services and providers of
maternity care.
