Dataset Information

National trends in antidepressant medication treatment among publicly insured pregnant women.

ABSTRACT:

Objective

The risk of depression in women is greatest at childbearing age. We sought to examine and explain national trends in antidepressant use in pregnant women.

Methods

This was a cohort study including pregnant women aged 12-55 who were enrolled in Medicaid during 2000-2007. We examined the proportion of women taking antidepressants during pregnancy by patient characteristics (descriptive), by region (mixed-effects model) and over time (interrupted time series).

Results

We identified 1,106,757 pregnancies in 47 states; mean age was 23 years, and 60% were nonwhite. Nearly 1 in 12 used an antidepressant during pregnancy. Use was higher for older (11.2% for age ?30 vs. 7.6% for <30) and white (14.4% vs. 4.0% for nonwhite) women. There was a four- to fivefold difference in rate of antidepressant use among states. Of the 5.3% of women taking antidepressants at conception, 33% and 17% were still on treatment 90 and 180 days, respectively, into pregnancy; an additional 4% began use during pregnancy. Labeled pregnancy-related health advisories did not appear to affect antidepressant use.

Conclusions

Antidepressant use during pregnancy remains high in this population; treatment patterns vary substantially by patient characteristics and region. Comparative safety and effectiveness data to help inform treatment choices are needed in this setting.

SUBMITTER: Huybrechts KF

PROVIDER: S-EPMC4077674 | biostudies-literature | 2013 May-Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

National trends in antidepressant medication treatment among publicly insured pregnant women.

Huybrechts Krista F KF Palmsten Kristin K Mogun Helen H Kowal Mary M Avorn Jerry J Setoguchi-Iwata Soko S Hernández-Díaz Sonia S

General hospital psychiatry 20130130 3

<h4>Objective</h4>The risk of depression in women is greatest at childbearing age. We sought to examine and explain national trends in antidepressant use in pregnant women.<h4>Methods</h4>This was a cohort study including pregnant women aged 12-55 who were enrolled in Medicaid during 2000-2007. We examined the proportion of women taking antidepressants during pregnancy by patient characteristics (descriptive), by region (mixed-effects model) and over time (interrupted time series).<h4>Results</h ...[more]

PMID: 23374897

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Project description:BackgroundInfants younger than 6 months are at increased risk of complications and mortality from pertussis infection. In October 2012, the Advisory Committee on Immunization Practices revised its recommendation to include a Tdap dose during each pregnancy, ideally between 27 and 36 weeks gestation.ObjectiveAssess trends in Tdap vaccination coverage among privately insured pregnant women from 2009 to 2016 including timing of Tdap vaccination (before, during, or after pregnancy), trimester of vaccination for women vaccinated during pregnancy, and missed vaccination opportunities for unvaccinated women. Identify factors associated with vaccination during the optimal period of 27-36 weeks gestation.Study designRetrospective analysis of privately insured women 15-49 years who delivered live births during 2009-2016 conducted using 2009-2016 MarketScan data. Tdap vaccination coverage and the timing of Tdap vaccine administration were assessed for women continuously enrolled from 6 months before pregnancy to 1 month after delivery. Multivariable logistic regression was performed to identify factors independently associated with receipt of Tdap vaccine at 27-36 weeks gestation.ResultsTdap vaccination coverage during pregnancy increased from 0.4% in 2009 to 6.2% in 2012 and to 53.2% in 2016. The proportion of vaccinated women receiving Tdap at 27-36 weeks gestation increased from <10% in 2009 to nearly 90% in 2016, with most vaccination occurring at 27-32 weeks gestation. Women of older age, residing in a metropolitan statistical area, residing outside the South, and having a capitated health insurance plan were more likely to receive Tdap at 27-36 weeks gestation than their counterparts. Among women not vaccinated during pregnancy, 77.7% had a pregnancy-related medical claim between 27 and 36 weeks gestation.ConclusionTdap vaccination coverage during pregnancy increased significantly from 2009 to 2016, with the greatest increase occurring after the revised Advisory Committee on Immunization Practices recommendation. Most women who did not receive Tdap vaccine had a missed vaccination opportunity during pregnancy, indicating potential for much higher vaccination coverage and consequent infant protection against pertussis.

Dataset Information

National trends in antidepressant medication treatment among publicly insured pregnant women.

Objective

Methods

Results

Conclusions

Publications

National trends in antidepressant medication treatment among publicly insured pregnant women.

Similar Datasets

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