To describe national, state-specific, and sociodemographic trends in diagnoses of depressive disorders recorded during delivery hospitalizations.
Data were analyzed from the National Inpatient Sample (2000–2015) and 31 publicly available State Inpatient Databases (2000–2015) of the Healthcare Cost and Utilization Project. Delivery hospitalizations were identified by using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) diagnostic and procedure codes for obstetric delivery. Depressive disorders were identified from ICD-9-CM diagnoses codes classified as depressive disorders in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (291.89, 292.84, 293.83, 296.2–296.26, 296.3–296.36, 300.4, and 311). Prevalence rates and average annual rate change were calculated nationally and across 28 states with at least 3 years of data and age, payer source, and race or ethnicity.
The U.S. rate of depressive disorders recorded during delivery hospitalizations increased from 4.1 diagnoses per 1,000 hospitalizations in 2000 to 28.7 in 2015. Rates significantly increased in 27 of the 28 states. Recent (2014–2015) rates were lowest in Hawaii and Nevada (less than 14/1,000) and highest in Vermont, Minnesota, Oregon, and Wisconsin (greater than 49/1,000). Rates in 2015 were highest among those aged 35 years or older, public insurance recipients, and non-Hispanic white women (greater than 31/1,000). The highest annual rate increases were in Vermont and Maine (3.8/1,000 or greater). Non-Hispanic white women, those 35 years of age or older, and public insurance recipients showed the highest annual rate increases during 2000–2015 (1.7/1,000 or greater).
During 2000–2015, rates of depressive disorders recorded during delivery hospitalizations increased nationally, in 27 states with available data, and across all sociodemographic categories.
From 2000 to 2015, rates of depressive disorders recorded during delivery hospitalizations increased nationally across age, insurance, and race or ethnicity categories.
Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; the University of Massachusetts Medical School, UMass Memorial Health Care, Worcester, Massachusetts; and the United States Public Health Service Commissioned Corps, Rockville, Maryland.
Corresponding author: Sarah C. Haight, MPH, 4770 Buford Hwy, MS-F74, Atlanta, GA 30341; email: email@example.com.
Financial Disclosure Nancy Byatt receives grant funding from the National Institutes of Health (R41 MH113381) and the Centers for Disease Control and Prevention (U01DP006093) for projects related to perinatal depression. Dr. Byatt receives salary and funding support from Massachusetts Department of Mental Health via the Massachusetts Child Psychiatry Access Program for Moms (MCPAP for Moms). Dr. Byatt is the founding and current statewide Medical Director of MCPAP for Moms. Dr. Byatt is also the Executive Director of Lifeline4Moms. Dr. Byatt is a member of the American College of Obstetricians and Gynecologists' Expert Work Group on Maternal Mental Health. She has served on the Perinatal Depression Advisory Board for the Janssen Disease Interception Accelerator Program, the Physician Advisory Board for Sage Therapeutics, and is a Council Member of the Gerson Lehrman Group. She has also received speaking honoraria from and serves a consultant for Sage Therapeutics or their agents and Ovia Health. Dr. Byatt has also received honoraria from Medscape and Miller Medical Communications. Tiffany A. Moore Simas receives grant funding from the National Institutes of Health (R41 MH113381) and the Centers for Disease Control and Prevention (U01DP006093) for projects related to perinatal depression. Dr. Moore Simas receives a stipend from the Massachusetts Department of Mental Health via Beacon for her role as Engagement Director of the Massachusetts Child Psychiatry Access Program for Moms (MCPAP for Moms). Dr. Moore Simas is Medical Director of Lifeline4Moms; she co-directs the American College of Obstetricians and Gynecologists' Expert Work Group on Maternal Mental Health and was a member of the Council on Patient Safety in Women's Health Care's task force for creation of the maternal mental health patient safety bundle and co-author on the associated commentary. Dr. Moore Simas has served on ad hoc Physician Advisory Boards for Sage Therapeutics, has received speaking honoraria, and serves as a consultant on observational studies and a systematic review. Dr. Moore Simas serves as a consultant to Ovia Health, has received compensation for reviewing a perinatal depression case for McGraw Hill, and has received speaking honoraria from Miller Medical Communications. The other authors did not report any potential conflicts of interest.
Presented as a poster at the World Psychiatric Association Epidemiology and Public Health Section meeting: Emerging Mental Health Challenges Across the Globe, May 2–4, 2018, New York, NY.
The findings and conclusions in this report are those of the authors and do not necessarily reflect the official position of the CDC.
A list of states participating in the State Inpatient Databases, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality is available at www.hcup-us.ahrq.gov/hcupdatapartners.jsp.
Peer reviews are available at http://links.lww.com/AOG/B386.