Clinically Identified Maternal Depression Before, During, and After Pregnancies Ending in Live Births

TLDR

The study aimed to estimate the prevalence of diagnosed depression and its treatment among women before, during, and after pregnancies ending in live births. Using a validated algorithm on health plan data from 1998–2001, the authors identified continuously enrolled women with live‑birth pregnancies, determined depression from medical records, and defined treatment as antidepressant medication and/or mental health visits. Among 4,398 women, 15.4% had depression in at least one pregnancy phase (8.7% before, 6.9% during, 10.4% after); 56.4% of those depressed before also had depression during, 54.2% of those after had depression before or during, most received antidepressants or mental‑health visits, but antidepressant use was lower during pregnancy, and overall about one in seven women were identified and treated for depression across the 39‑week pre‑ and post‑pregnancy periods.

Abstract

This study estimated the prevalence of diagnosed depression and treatment among women before, during, and after pregnancies ending in live births.A previously validated algorithm identified health plan members with at least one pregnancy between Jan. 1, 1998, and Dec. 31, 2001. Women with a pregnancy ending in one or more live births and continuously enrolled from 39 weeks before pregnancy through 39 weeks after pregnancy were eligible. Maternal depression was identified from the medical records. Depression treatment included antidepressant medication and/or mental health visits. The authors examined the prevalence of depression and treatments received.Among 4,398 continuously enrolled women with eligible pregnancies ending in live births, 678 (15.4%) had depression identified during at least one pregnancy phase; 8.7%, 6.9%, and 10.4% had depression identified before, during, and/or after pregnancy, respectively. Among women with identified depression during the 39 weeks before pregnancy, 56.4% also had a depression diagnosis during pregnancy. Of women identified with depression during the 39 weeks following pregnancy, 54.2% had depression diagnoses either during or preceding pregnancy. Most women diagnosed with depression received antidepressant medications and/or had at least one mental health visit. Having at least one mental health visit did not vary before, during, or after pregnancy; however, antidepressant use was lower during pregnancy than before or after pregnancy.Approximately one in seven women was identified with and treated for depression during 39 weeks before through 39 weeks after pregnancy, and more than half of these women had recurring indicators for depression.