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To describe perinatal mental health outcomes among people with intellectual disability giving birth in New South Wales, Australia.

This retrospective, descriptive cohort study included 30,257 people (2262 people with intellectual disability and 27,995 comparators without intellectual disability) aged 10+ years, discharged from New South Wales hospitals between 2002 and 2017 following a live singleton birth. We used administrative data from emergency departments, hospitals, ambulatory mental health services, Medicare-subsidised services and the Pharmaceutical Benefits Scheme. We defined the overall perinatal period as 140 days before to 365 days after birth. We also examined outcomes within four specific timeframes: 140 days to birth, 1-42, 43-90 and 91-365 days after birth.

Across the overall perinatal period, people with intellectual disability who gave birth had greater risk of having at least one mental health emergency department presentation (risk ratio = 7.01 (5.78-8.50)), mental health hospital admission (risk ratio = 8.97 (7.54-10.67)), ambulatory mental health service contact (risk ratio = 5.55 (4.90-6.28)) and Medicare-subsidised mental health service contact (risk ratio = 1.99 (1.82-2.16)) than comparators. The most common diagnoses among people with intellectual disability were mood (12.6%; risk ratio = 3.83 (3.38-4.35)) and anxiety, stress-related and somatoform disorders (11.9%; risk ratio = 3.62 (3.19-4.12)). People with intellectual disability were more likely to be dispensed antipsychotics (risk ratio = 9.29 (7.74-11.16)), anxiolytics (risk ratio = 3.03 (2.44-3.76)), hypnotics/sedatives (risk ratio = 2.08 (1.55-2.78)), antidepressants (risk ratio = 2.30 (2.13-2.49)) and psychostimulants (risk ratio = 4.00 (2.03-7.89)).

Our findings show elevated use of mental health services by people with intellectual disability in the perinatal period and underscore the need for accessible and adequately equipped acute and community-based mental health services.