Assessing Factors that Influence Psychiatric Referral Time and Postpartum Follow-Up in Obstetric Patients

Area of Science:

• Reproductive Psychiatry
• Obstetrics
• Mental Health Disparities

Background:

• Significant shortage of psychiatric care for peripartum obstetric patients in the US.
• Variability in mental illness screening and care availability creates healthcare gaps, especially for non-white patients.
• Postpartum appointment attendance is affected by race, ethnicity, and socioeconomic status, worsening disparities.

Purpose of the Study:

• To determine if psychiatric referral timing (prenatal vs. postnatal) affects engagement with reproductive psychiatrists.
• To investigate how seeing a reproductive psychiatrist impacts postpartum healthcare follow-up in obstetric patients.

Main Methods:

• Chart review of 71 obstetric patients referred to a reproductive psychiatrist in 2023.
• Data collected: demographics, substance use, psychotropic medication use, psychiatric diagnoses.
• Chi-squared tests analyzed referral timing and loss to postpartum follow-up.

Main Results:

• Patients referred prenatally were 3.26 times more likely to meet with a reproductive psychiatrist (62%) compared to those referred postnatally.
• Meeting with a reproductive psychiatrist was associated with 3.63 times lower odds of being lost to postpartum healthcare follow-up.
• Factors like substance use, psychotropic medication, and specific diagnoses influenced referral timing and follow-up rates.

Conclusions:

• Early (prenatal) psychiatric referral enhances patient engagement with reproductive psychiatrists.
• Meeting with a reproductive psychiatrist improves postpartum healthcare follow-up rates.
• Understanding factors influencing referral and follow-up can help providers optimize care and reduce disparities.