Examining Psychiatric Comorbidities and Demographic Links in Hawaii’s Pregnant Population
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2025
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Introduction: Psychiatric comorbidities are common in pregnancy, with as many as 1 in 5 women suffering from a mental health or substance use disorder during the perinatal period. These psychiatric comorbidities have the potential to negatively impact the health and care of both the mother and fetus. Given Hawaii’s distinct and diverse population composition, it is imperative that the demographics and psychiatric comorbidities of pregnant women in Hawaii are described. Identification of these factors may promote more inclusive and informed healthcare and educational practices.
Objectives: This study aims to describe the demographic factors, including age, race/ethnicity, financial status, educational background, and obstetric history of pregnant patients with psychiatric comorbidities.
Methods: We conducted a cross-sectional web-based survey of individuals who were female sex-assigned at birth, ages 18-45, Hawaii residents, with reproductive potential, and with self-reported mental health disorders. Recruitment relied on flyers in OBGYN, primary care provider, and psychiatry clinics and social media postings between September 2021 to September 2022. We compiled descriptive statistics using Microsoft Excel and SPSS 29.0.
Results: We received 98 complete responses. Eighty (81.6%) respondents reported having a psychiatric disorder. Self-reported mental health diagnoses included 54 (68%) responses for anxiety, 18 (23%) for ADHD, 8 (10%) for bipolar disorder, 54 (68%) for depression, 6 (8%) for eating disorders, 7 (9%) for OCD, 20 (25%) for PTSD, 1 (1%) for schizophrenia/schizoaffective disorder, 8 (9%) for substance use disorder, 6 (6%) for other, 8 (10%) for none, and 46 (58%) for multiple. Race/ethnicity composition of those with a psychiatric disorder included 36 (45%) Native Hawaiian, 9 (11%) Pacific Islander, 34 (43%) Asian, 39 (48%) White, 4 (5%) Black, 2 (3%) Native American/Alaska Native, and 6 (8%) Latina. 37 (46%) respondents reported obtaining financial assistance. The vast majority of respondents (84%) had some college education or more, and the majority of respondents (54%) were 19-30 years old. Most respondents (73%) had been pregnant before. Respondents had varied pregnancy history, with 22 (28%) nulliparous, 58 (73%) parous, and 23 (29%) respondents who were currently pregnant.
Discussion: It is not uncommon for pregnant patients to manage psychiatric comorbidities, and in our sample, these diagnoses spanned socioeconomic, racial, and educational backgrounds. Medical education should focus on normalizing and improving psychiatric screening in pregnancy and achieving competence with management of medications, psychological supports, and anticipatory guidance for patients navigating the transition to parenthood. Future research should focus on how equipped medical students and primary care providers feel to address the psychiatric needs of patients during pregnancy.
Target audience: Healthcare providers, educators, and researchers involved with maternal and mental healthcare.
References: American Psychiatric Association. Perinatal Mental Health and Substance Use Disorders: A White Paper on the Status of Care in the United States. American Psychiatric Association; 2023. Accessed November 2, 2024. https://www.psychiatry.org/getmedia/344c26e2-cdf5-47df-a5d7-a2d444fc1923/APA-CDC-Perinatal-Mental-and-Substance-Use-Disorders-Whitepaper.pdf
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