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Research article
Perinatal Mood and Anxiety Disorders, Serious Mental Illness, and Delivery-Related Health Outcomes, United States, 2006-2015
Kimberly Schmitt McKee
University of Michigan Medical School
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2905-5000
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Women's Health.
Background: National estimates of perinatal mood and anxiety disorders (PMAD) and serious mental illness (SMI) among delivering women over time, as well as associated outcomes and costs, are lacking. The prevalence of perinatal mood and anxiety disorders and serious mental illness from 2006-2015 were estimated as well as associated risk of adverse obstetric outcomes, including severe maternal morbidity and mortality (SMMM), and delivery costs.
Methods: The study was a serial, cross-sectional analysis of National Inpatient Sample data. The prevalence of PMAD and SMI was estimated among delivering women as well as obstetric outcomes, healthcare utilization, and delivery costs using adjusted weighted logistic with predictive margins and generalized linear regression models, respectively.
Results: The study included an estimated 39,025,974 delivery hospitalizations from 2006-2015 in the U.S. PMAD increased from 18.4 (95% CI 16.4-20.0) to 40.4 (95% CI 39.3-41.6) per 1,000 deliveries. SMI also increased among delivering women over time, from 4.2 (95% CI 3.9-4.6) to 8.1 (95% CI 7.9-8.4) per 1,000 deliveries. Medicaid covered 72% (95% CI 71.2-72.9) of deliveries complicated by SMI compared to 44% (95% CI 43.1-45.0) and 43.5% (95% CI 42.5-44.5) among PMAD and all other deliveries, respectively. Women with PMAD and SMI experienced higher incidence of SMMM, and increased hospital transfers, lengths of stay, and delivery-related costs compared to other deliveries (P<.001 for all).
Conclusion: Over the past decade, the prevalence of both PMAD and SMI among delivering women increased substantially across the United States, and affected women had more adverse obstetric outcomes and delivery-related costs compared to other deliveries.
Keywords
Perinatal mood and anxiety disorders; serious mental illness; depression/anxiety; pregnancy; severe maternal morbidity and mortality
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This preprint is under consideration at BMC Women's Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Perinatal Mood and Anxiety Disorders, Serious Mental Illness, and Delivery-Related Health Outcomes, United States, 2006-2015
Kimberly Schmitt McKee
University of Michigan Medical School
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2905-5000
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 4
Posted 13 Jun, 2020
Published
On 23 Jul, 2020
No community comments so far
Submission checks complete
On 11 Jun, 2020
Editorial decision: Minor revision
On 11 Jun, 2020
No comments provided
Editorial decision: Minor revision
On 29 May, 2020
Editor assigned
On 19 May, 2020
Submission checks complete
On 18 May, 2020
Editor invited
On 18 May, 2020
No comments provided
Review #1 received
Received 01 Apr, 2020
Editorial decision: Minor revision
On 01 Apr, 2020
Reviewers invited
Invitations sent on 31 Mar, 2020
Reviewer #1 agreed
On 31 Mar, 2020
Editor assigned
On 02 Mar, 2020
Submission checks complete
On 01 Mar, 2020
Editor invited
On 01 Mar, 2020
No comments provided
Editorial decision: Minor revision
On 10 Feb, 2020
Review #2 received
Received 04 Feb, 2020
Review #1 received
Received 04 Feb, 2020
Reviewer #3 agreed
On 25 Jan, 2020
Reviewer #2 agreed
On 01 Dec, 2019
Reviewer #1 agreed
On 20 Nov, 2019
Editor assigned
On 04 Nov, 2019
Reviewers invited
Invitations sent on 04 Nov, 2019
Editor invited
On 04 Nov, 2019
Submission checks complete
On 03 Nov, 2019
First submitted
On 29 Oct, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Women's Health.
Background: National estimates of perinatal mood and anxiety disorders (PMAD) and serious mental illness (SMI) among delivering women over time, as well as associated outcomes and costs, are lacking. The prevalence of perinatal mood and anxiety disorders and serious mental illness from 2006-2015 were estimated as well as associated risk of adverse obstetric outcomes, including severe maternal morbidity and mortality (SMMM), and delivery costs.
Methods: The study was a serial, cross-sectional analysis of National Inpatient Sample data. The prevalence of PMAD and SMI was estimated among delivering women as well as obstetric outcomes, healthcare utilization, and delivery costs using adjusted weighted logistic with predictive margins and generalized linear regression models, respectively.
Results: The study included an estimated 39,025,974 delivery hospitalizations from 2006-2015 in the U.S. PMAD increased from 18.4 (95% CI 16.4-20.0) to 40.4 (95% CI 39.3-41.6) per 1,000 deliveries. SMI also increased among delivering women over time, from 4.2 (95% CI 3.9-4.6) to 8.1 (95% CI 7.9-8.4) per 1,000 deliveries. Medicaid covered 72% (95% CI 71.2-72.9) of deliveries complicated by SMI compared to 44% (95% CI 43.1-45.0) and 43.5% (95% CI 42.5-44.5) among PMAD and all other deliveries, respectively. Women with PMAD and SMI experienced higher incidence of SMMM, and increased hospital transfers, lengths of stay, and delivery-related costs compared to other deliveries (P<.001 for all).
Conclusion: Over the past decade, the prevalence of both PMAD and SMI among delivering women increased substantially across the United States, and affected women had more adverse obstetric outcomes and delivery-related costs compared to other deliveries.
Figure 1