Perinatal mood and anxiety disorders almost doubled from 2008-2020
April 19, 2024
Increase in Perinatal Mood and Anxiety Disorders (PMAD) among those with private insurance
Source: Zivin, et al Health Affairs April, 2024 LINK
Anxiety and depression rates have soared since the pandemic - but the increase started substantially earlier. Perinatal mood and anxiety disorders (PMAD) have increased as well, and this is associated with worse maternal and neonatal outcomes. A review of Maternal Mortality Conference records published in 2021 showed that one in 9 maternal deaths had mental health conditions as an underlying cause.
Researchers studied de-identified medical claims data from the Optum data warehouse and demonstrated a 93% increase in diagnosis of mood disorders and anxiety among those giving birth. They noted that the slope increased in 2014 as the regulations of the Affordable Care Act went into effect and more people had coverage for mental health diagnosis and treatment. Their research was published this month in Health Affairs.
The good news is that more women with PMAD got treatment. The figure below shows the increase in psychotherapy for PMAD beginning in 2014.
Psychotherapy among privately insured women with PMAD
Source: Zivin, et al Health Affairs April, 2024 LINK
Additional further good news is that the likelihood of women diagnosed with PMAD would have a diagnosis of suicidality diminished as more were treated with psychotherapy after 2014. This estimate of psychotherapy may be an undercount, as some mothers may pay for psychotherapy out of pocket.
Suicidality among privately-insured women diagnosed with PMAD
Source: Zivin, et al Health Affairs April, 2024 LINK
Implications for employers:
- Employers can help prevent maternal deaths by offering access to mental health services that can be accessed quickly, either through their EAP or another medical carrier.
- Plans complying with mental health parity requirements may reduce bad outcomes for the mother and the newborn.
- Paid parental leave can also help improve perinatal mental health.