Hoe bevalt de POP-poli?

Meegdenburg, J. van (Jil) (2015) Hoe bevalt de POP-poli? thesis, Medicine.

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Abstract

Background. Psychiatric disorders occur in about 15% of pregnant women. The combination of psychiatric disorders and pregnancy can be difficult for caregivers. Therefore in the Netherlands, POP-polyclinics are set up, where gynaecologists, psychiatrists, and paediatricians work together to provide extra care for pregnant women with psychiatric disorders. Despite the raising awareness of POP-polyclinics and increasing patients numbers, there has not been a study to the results of these polyclinics. Methods. Retrospectively, we studied all women who gave birth in the Isala Clinics between 2009 and 2013 (N = 16752). Patients that visited the POP-polyclinic (n = 609) were compared to patients that received general care (n = 15097). We also sent out 256 questionnaires to all POP-patients who gave birth in Isala, to determine how they experienced the POP-polyclinic. Results. POP-patients used, during pregnancy, significantly more nicotine (20% versus 11%, P < 0.001) and took significantly more often psychopharmaceuticals (35% versus 2%, P < 0.001) than general patients. They visited significantly more often a gynaecologist or midwife (16 visits versus 11 visits, P < 0.001 ), were hospitalized significantly longer during pregnancy and labour (3 days versus 2 days, P < 0.001) and gave birth significantly earlier than general patients (38 versus 39 weeks, P < 0.001). General patients had significantly more often spontaneous labour (59% versus 47%, P < 0.001), while POP-patients were significantly more often induced (41% versus 32%, P < 0.001). Nevertheless, there was no significant difference with help by labour or complications during labour. Concerning the new-borns, only the birth weight was significantly different between POP-patients and general patients (3273 g versus 3432 g, P < 0.001). Within the POP-group, new-borns of POP-patients who used psychopharmaceuticals had significantly lower APGAR-scores (after one, five and ten minutes: 9-9-10 versus 9-10-10, P < 0.001). Clinically, however, these differences in APGAR scores are not relevant. Furthermore, these newborns were more often admitted to the paediatric ward than children of POP-patients who did not use psychopharmaceuticals (19% versus 8%, P < 0.001). The questionnaire showed that the POP-polyclinic provided POP-patients stability, gave them reassurance, and reduced their stress-level. Conclusion. Extra care and attention seem to provide a safe environment for POP-patients. Nevertheless, they give birth earlier than general patients, probably because of substance abuse and use of psychopharmaceuticals. Despite this, there are good outcomes for POP-patients and their new-borns. New-borns of POP-patients who use psychopharmaceuticals, however, do have lower APGAR scores and get more often hospitalised than new-borns of POP-patients that not use psychopharmaceuticals.

Item Type:	Thesis (Thesis)
Supervisor name:	Dijkstra, Drs. J.R. and Locatie: Isala, Afdeling Gynaecologie & Obstetrie
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:43
Last Modified:	25 Jun 2020 10:43
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/452

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