Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Mar 7:12:1345442.
doi: 10.3389/fpubh.2024.1345442. eCollection 2024.

Diagnosed behavioral health conditions during the perinatal period among a commercially insured population by race/ethnicity, 2008-2020

Dana C Beck  1 , Karen Tabb  2 , Anca Tilea  3 , Ashlee J Vance  4 , Stephanie Hall  5 , Amy Schroeder  5 , Kara Zivin  3   5   6
Affiliations

Diagnosed behavioral health conditions during the perinatal period among a commercially insured population by race/ethnicity, 2008-2020

Dana C Beck et al. Front Public Health. .

Abstract

Objective: We sought to examine trends in diagnosed behavioral health (BH) conditions [mental health (MH) disorders or substance use disorders (SUD)] among pregnant and postpartum individuals between 2008-2020. We then explored the relationship between BH conditions and race/ethnicity, acknowledging race/ethnicity as a social construct that influences health disparities.

Methods: This study included delivering individuals, aged 15-44 years, and continuously enrolled in a single commercial health insurance plan for 1 year before and 1 year following delivery between 2008-2020. We used BH conditions as our outcome based on relevant ICD 9/10 codes documented during pregnancy or the postpartum year.

Results: In adjusted analyses, white individuals experienced the highest rates of BH conditions, followed by Black, Hispanic, and Asian individuals, respectively. Asian individuals had the largest increase in BH rates, increasing 292%. White individuals had the smallest increase of 192%. The trend remained unchanged even after adjusting for age and Bateman comorbidity score, the trend remained unchanged.

Conclusions: The prevalence of diagnosed BH conditions among individuals in the perinatal and postpartum periods increased over time. As national efforts continue to work toward improving perinatal BH, solutions must incorporate the needs of diverse populations to avert preventable morbidity and mortality.

Keywords: SUD; behavioral health; maternal mental health; perinatal mental health; racial disparities; rates of mental health problems.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
Unadjusted predicted rate of behavioral health conditions per 10,000 deliveries, by race/ethnicity, between 2008–2020 in a national commercially insured sample of perinatal individuals. Unadjusted rate of behavioral health (BH) conditions by race/ethnicity.
Figure 2
Figure 2
Adjusted predicted rate of behavioral health conditions per 10,000 deliveries, by race/ethnicity, between 2008–2020 in a national commercially insured sample of perinatal individuals. Adjusted rates of BH conditions by race/ethnicity adjusting for age, geographic region, insurance type, income, delivery mode, and Bateman index score.
See this image and copyright information in PMC

References

    1. Margerison CE, Roberts MH, Gemmill A, Goldman-Mellor S. Pregnancy-associated deaths due to drugs, suicide, and homicide in the United States, 2010-2019. Obstet Gynecol. (2022) 139:172–180. 10.1097/AOG.0000000000004649 - DOI - PMC - PubMed
    1. American College of Obstetricians and Gynecologists . Treatment and management of mental health conditions during pregnancy and postpartum. Obstetr Gynecol. (2023) 141:1262–1288. 10.1097/AOG.0000000000005202 - DOI - PubMed
    1. Lett E, Asabor E, Beltrán S, Cannon AM, Arah OA. Conceptualizing, contextualizing, and operationalizing race in quantitative health sciences research. Ann Fam Med. (2022) 20:157–163. 10.1370/afm.2792 - DOI - PMC - PubMed
    1. HCUP CCS-Services and Procedures . Healthcare Cost and Utilization Project (HCUP). Agency for Healthcare Research and Quality, Rockville, MD (2018). Available online at: www.hcup-us.ahrq.gov/toolssoftware/ccs_svcsproc/ccssvcproc.jsp (accessed May 30, 2023).
    1. Bateman BT, Mhyre JM, Hernandez-Diaz S, Huybrechts KF, Fischer MA, Creanga AA, et al. . Development of a comorbidity index for use in obstetric patients. Obstet Gynecol. (2013) 122:957–965. 10.1097/AOG.0b013e3182a603bb - DOI - PMC - PubMed

Publication types