Tohoku J. Exp. Med., 2021 February, 253(2)

Impact of a Psychiatric Nurse Specialist as a Liaison for Pregnant Women with Mental Disorders

Shunichiro Tsuji,¹ Kumiko Fujii,² Mitsuko Ando,³ Daisuke Katsura,¹ Yutaka Yoneoka,⁴ Tsukuru Amano,¹ Yurika Yamada,³ Misawo Noda,³ Nao Kamagahara,³ Ai Nakai,³ Yuji Ozeki,² Fuminori Kimura¹ and Takashi Murakami¹

¹Department of Obstetrics and Gynecology, Shiga University of Medical Science, Otsu, Shiga, Japan
²Department of Psychiatry, Shiga University of Medical Science, Otsu, Shiga, Japan
³Nursing Division, Shiga University of Medical Science, Otsu, Shiga, Japan
⁴National Hospital Organization Higashi-ohmi General Medical Center, Higashi-ohmi, Shiga, Japan

A number of scholarly reports have shown the importance of mental health care during pregnancy, especially for women with mental disorders. Nevertheless, the postpartum mortality rate due to mental disorders has been a serious issue in Japan. Therefore, since January 2015, our hospital has implemented a liaison system in which one psychiatric nurse specialist contributes to perinatal care. The aim of this study is to explore the impacts of a psychiatric nurse specialist as a liaison for pregnant women with mental disorders. More specifically, the investigation was retrospectively performed from January 2011 to December 2019 using medical records from a single university medical hospital in Japan. Participants comprised pregnant women with mental disorders. Of the 4,066 total deliveries completed during the study period, 152 women were detected as being exposed to the liaison system (2015-2019), while 92 were recognized as controls (2011-2014). We then conducted a comparative analysis between those who were exposed to the liaison system and the control group. Except for Apgar scores taken five minutes after birth, there were no intergroup differences in the patient characteristics or perinatal psychiatric outcomes. We found that the liaison system was associated with an increased rate of referral to the local public health center (p = 0.003). The system also significantly delayed the time at which patients first visited a psychiatrist because a psychiatric nurse could determine the urgency through interviews with the patients. Overall, our results suggest that the liaison system is helpful for pregnant women with mental disorders.

Keywords —— liaison nurse; mental disorder; mental health care; pregnancy; psychiatric nurse specialist

© 2021 Tohoku University Medical Press

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Tohoku J. Exp. Med 2021 February, 253(2), 95-99.

Correspondence: Shunichiro Tsuji, Department of Obstetrics and Gynecology, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga 520-2192, Japan.

e-mail: tsuji002@belle.shiga-med.ac.jp