Psychiatric mother and baby units (MBUs) are recommended for severe perinatal mental illness, but effectiveness compared with other forms of acute care remains unknown.

We hypothesised that women admitted to MBUs would be less likely to be readmitted to acute care in the 12 months following discharge, compared with women admitted to non-MBU acute care (generic psychiatric wards or crisis resolution teams (CRTs)).

Quasi-experimental cohort study of women accessing acute psychiatric care up to 1 year postpartum in 42 healthcare organisations across England and Wales. Primary outcome was readmission within 12 months post-discharge. Propensity scores were used to account for systematic differences between MBU and non-MBU participants. Secondary outcomes included assessment of cost-effectiveness, experience of services, unmet needs, perceived bonding, observed mother–infant interaction quality and safeguarding outcome.

Of 279 women, 108 (39%) received MBU care, 62 (22%) generic ward care and 109 (39%) CRT care only. The MBU group (n = 105) had similar readmission rates to the non-MBU group (n = 158) (aOR = 0.95, 95% CI 0.86–1.04, P = 0.29; an absolute difference of −5%, 95% CI −14 to 4%). Service satisfaction was significantly higher among women accessing MBUs compared with non-MBUs; no significant differences were observed for any other secondary outcomes.

We found no significant differences in rates of readmission, but MBU advantage might have been masked by residual confounders; readmission will also depend on quality of care after discharge and type of illness. Future studies should attempt to identify the effective ingredients of specialist perinatal in-patient and community care to improve outcomes.

精神病母婴病房 (MBUs) 被推荐用于严重的围产期精神疾病，但与其他形式的急性护理相比的有效性仍然未知。

我们假设，与入住非 MBU 急症护理（普通精神病房或危机解决小组 (CRT)）的女性相比，入住 MBU 的女性在出院后 12 个月内再次接受急症护理的可能性较小。

在英格兰和威尔士的 42 个医疗保健机构中对产后 1 年内接受急性精神病治疗的女性进行准实验队列研究。主要结果是出院后 12 个月内再次入院。倾向得分用于解释 MBU 和非 MBU 参与者之间的系统差异。次要结果包括成本效益评估、服务体验、未满足的需求、感知到的联系、观察到的母婴互动质量和保护结果。

在 279 名女性中，108 名 (39%) 接受 MBU 护理，62 名 (22%) 接受普通病房护理，109 名 (39%) 仅接受 CRT 护理。MBU 组 ( n = 105) 的再入院率与非 MBU 组 ( n = 158) 相似（aOR = 0.95，95% CI 0.86–1.04，P = 0.29；绝对差异为 -5%，95% CI −14 至 4%）。与非 MBU 相比，使用 MBU 的女性的服务满意度明显更高；对于任何其他次要结果，未观察到显着差异。

我们发现再入院率没有显着差异，但 MBU 的优势可能被残留的混杂因素掩盖了；再次入院还取决于出院后的护理质量和疾病类型。未来的研究应尝试确定专科围产期住院和社区护理的有效成分，以改善结局。