This population-based retrospective cohort study used the US Nationwide Readmissions Database (2010–2020) to examine whether ischemic placental disease (preeclampsia, placental abruption, and/or fetal growth restriction) is associated with postpartum hospitalization for neurological and psychiatric disorders in women aged 15–54, within the calendar year of delivery.
Among 17,368,071 deliveries, 10.7% had ischemic placental disease. Brain disorder hospitalization rates were 1,219 vs. 730 per 10,000 deliveries (with vs. without ischemic placental disease; adjusted HR 1.50, 95% CI 1.48–1.51). Risk rose in a dose-dependent fashion: HR 1.47 with 1 condition, 1.66 with 2, and 1.85 with all 3.
- Administrative claims data rely on coded diagnoses, introducing potential outcome misclassification (though quantitative bias analysis was applied). - Unmeasured confounding cannot be fully excluded despite bias corrections. - Follow-up was limited to the calendar year of delivery, so longer-term outcomes are not captured.
Women with ischemic placental disease face a ~50% higher risk of hospitalization for brain disorders—including stroke, depression, PTSD, and suicide attempt—within the postpartum year. Clinicians should treat ischemic placental disease as a neurological and psychiatric risk signal, prompting closer postpartum mental health and neurological surveillance.
