• Posted April 2, 2024

Big Improvements Seen in Spotting, Treating Mental Health Issues Around Pregnancy

Expecting or new mothers are much more likely these days to be diagnosed with anxiety, depression and post-traumatic stress disorder, new research shows.

However, more women are also getting treated for these problems rather than roughing it out, researchers report in April 1 issue of the journal Health Affairs.

“Taken together, these studies show a lot of movement in maternal mental health,” said researcher Stephanie Hall, a postdoctoral fellow at the University of Michigan Medical School. “The landscape is different, at least as far as our health care system's ability to pick up on conditions and help people get treatment for them.”

For the research, investigators analyzed claims data for people with private insurance between 2008 and 2020. They specifically looked for depressive and anxiety disorders occurring during pregnancy or in the first year of motherhood.

By 2020, more than one in four (28%) women received a diagnosis of a mood disorder during either pregnancy or the first year of parenthood – a rate nearly double that seen in 2008.

Further, the rate of PTSD diagnosis among expecting or new moms quadrupled, rising to nearly 2% of all those pregnant or postpartum in 2020.

Fortunately, treatment also appeared to increase alongside diagnoses, researchers said.

The rate at which new or expecting moms received talk therapy more than doubled, rising 16% for women diagnosed with anxiety, depression or PTSD, results show.

Antidepressant prescriptions also rose overall, and they rose fastest among those diagnosed with a mood disorder, researchers found. By 2020, just under half of those diagnosed with pregnancy-related depression had a prescription for an antidepressant.

“If anything, the rates we're documenting for diagnosis and treatment are a floor, not a ceiling, based on what other studies have suggested about who is experiencing these symptoms,” said researcher Kara Zivin, a professor with the University of Michigan Medical School. “It's important that those who are struggling get help, because not getting care has consequences.”

In fact, timely diagnosis and treatment appeared to ward off the most dire consequences of pregnancy-related mood disorders, the results indicated.

Suicidal thoughts or actions among pregnant women or new moms more than doubled overall between 2008 and 2020, but these diagnoses dropped among those who'd been diagnosed and treated for anxiety, depression or PTSD.

“Perinatal mental health has broad implications for babies and families,” Zivin said in a university news release. “The changes we've documented in these studies will have ripple effects for years to come.”

Researchers suspect diagnosis and treatment increased due to the Affordable Care Act (ACA) and other laws that promote treatment of mental illness.

ACA marketplaces started offering insurance plans in 2014. The rate of mood-disorder diagnoses related to pregnancy or new motherhood increased sharply in 2015, as did the rates of therapy and antidepressant prescriptions, researchers noted.

In addition, updated guidelines have emphasized the increased use of screening, therapy and medication for women during and after pregnancy, researchers said.

However, race-based disparities in diagnosis and care remain, the researchers noted.

White women were much more likely to receive antidepressant prescriptions during pregnancy than women of other races, results showed.

Whites were also more likely to be diagnosed with pregnancy-related PTSD, even though the actual incidence of PTSD is greater among people of color during and after pregnancy, researchers said.

On the other hand, Black expecting and new moms as a group had the largest increase in diagnoses of mood disorders during the study period.

More information

The National Institute of Mental Health has more about perinatal depression.

SOURCE: University of Michigan, news release, April 1, 2024