ESTIMATES OF POSTPARTUM DEPRESSION PREVALENCE IN A COMMERCIALLY INSURED POPULATION – A RETROSPECTIVE ANALYSIS

• Published in: Value in health Vol. 20; no. 5; p. A350
• Main Authors: Bonthapally, V, Broder, MS, Tieu, RS, Gannu, L, Meltzer-Brody, S, Chang, E
• Format: Journal Article
• Language: English
• Published: Lawrenceville Elsevier Science Ltd 01.05.2017
• Subjects: Childbirth & labor; Claims; Depressive personality disorders; Insurance; Mental depression; Mother-infant relations; Mother-offspring interactions; Population studies; Postpartum; Postpartum depression; Postpartum period; Postpartum women; Prevalence; Sensitivity analysis; Severity
• ISSN: 1098-3015; 1524-4733

OBJECTIVES: Postpartum Depression (PPD) is a common complication of childbirth and is associated with impaired maternal function and poor mother-infant interactions. Prevalence estimates vary depending on setting, evaluation method, and observation period. The objective of this study was to estimate PPD prevalence in a large, nationally-representative commercial insurance claims database. METHODS: This retrospective study used the Truven MarketScan Commercial Claims database. to identify women who gave birth between 2011- 2014, were 15-50 years old, and were continuously enrolled in insurance one year before and one year after delivery. The main analysis used a 6-month postpartum observation period to identify PPD cases based on ICD-9 coding for diagnoses and treatment claims. Women with major depressive disorder prior to the third trimester were excluded. Restrictions were removed for sensitivity analyses (SA). RESULTS: During the 6-month postpartum observation period, algorithmbased PPD prevalence estimates were 2.6%, 3.2%, and 3.7% for 2012, 2013, and 2014, respectively. Stratified by severity, most cases were moderate (95.4%). In SA1 (allowing pre-existing MDD), the prevalence was 4.5%, 5.4%, and 5.8%, respectively, in the 3 years studied. In SA 2 (extending to 12 months postpartum) it was 4.3%, 4.9%, and 5.5%, respectively. Combining both SAs yielded prevalence estimates of 7.3%, 8.1%, and 8.4%, respectively. CONCLUSIONS: Based on the algorithm, PPD prevalence in this commercially insured population increased from 26 per 1000 persons to 37 per 1000 persons from 2012-2014. In 2014, prevalence estimates ranged between 3.7% and 8.4%. These prevalence estimates are lower than in other studies in which all postpartum women in the studied population were screened for PPD at routine postpartum obstetrical visits, suggesting that PPD maybe be underdiagnosed.