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Prenatal Depression: Assessment and Outcomes among Medicaid Participants

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Abstract

This study used bivariate and regression-adjusted analyses of participant-level survey and medical data to investigate prevalence of depression among pregnant Medicaid participants, correlates of depression, and the relationship between depression and pregnancy outcomes. The sample included Medicaid participants with a single gestation and valid depression data who were enrolled in Strong Start for Mothers and Newborns 2, a national preterm birth prevention program, from 2013 to 2017 (N = 37,287; 85% of total enrollment). Depression rates in Strong Start were high (27.5%). Depression was associated with being black; having other children, an unplanned pregnancy, or challenges accessing prenatal care; not having a co-resident spouse or partner; and experiencing intimate partner violence. After these and other risk factors were controlled for, depression remained associated with higher rates of preterm birth. Systematic screening and holistic approaches to prenatal care that address depression and associated risks could help reduce rates of preterm birth and other poor pregnancy outcomes.

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References

  1. National Institute of Mental Health. Major Depression. https://www.nimh.nih.gov/health/statistics/major-depression.shtml. Published 2018. Accessed July 31, 2018.

  2. Ahluwalia IB, Holtzman D, Mack KA, et al. Observations from the CDC. Health-related quality of life among women of reproductive age: Behavioral risk factor surveillance system (BRFSS), 1998–2001. Journal of Women’s Health. 2003;12(1):5–9.

    Article  Google Scholar 

  3. National Institute of Mental Health. Depression. https://www.nimh.nih.gov/health/topics/depression/index.shtml. Published 2018. Accessed July 31, 2018.

  4. National Institute of Mental Health. Chronic Illness & Mental Health. https://www.nimh.nih.gov/health/publications/chronic-illness-mental-health/index.shtml. Published 2018. Accessed July 31, 2018.

  5. Enns J, Holmqvist M, Wener P, et al. Mapping interventions that promote mental health in the general population: A scoping review of reviews. Preventive Medicine. 2016;87:70–80.

    Article  Google Scholar 

  6. Ahrnsbrak R, Bose J, Hedden SL, et al. Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health. Rockville, MD, USA: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration; 2017.

    Google Scholar 

  7. Toivonen KI, Oinonen KA, Duchene KM. Preconception health behaviours: A scoping review. Preventive Medicine. 2017;96:1–15.

    Article  Google Scholar 

  8. Chaudron LH. Complex challenges in treating depression during pregnancy. American Journal of Psychiatry. 2013;170(1):12–20.

    Article  Google Scholar 

  9. Gavin NI, Gaynes BN, Lohr KN, et al. Perinatal depression: a systematic review of prevalence and incidence. Obstetrics & Gynecology. 2005;106(5):1071–1083.

    Article  Google Scholar 

  10. Melville JL, Gavin A, Guo Y, et al. Depressive disorders during pregnancy: prevalence and risk factors in a large urban sample. Obstetrics & Gynecology. 2010;116(5):1064.

    Article  Google Scholar 

  11. Venkatesh KK, Nadel H, Blewett D, et al. Implementation of universal screening for depression during pregnancy: feasibility and impact on obstetric care. American Journal of Obstetrics and Gynecology. 2016;215(4):517–e1.

    Article  Google Scholar 

  12. Bansil P, Kuklina EV, Meikle SF, et al. Maternal and fetal outcomes among women with depression. Journal of Women’s Health. 2010;19(2):329–334.

    Article  Google Scholar 

  13. Cullen SW, Matejkowski JC, Marcus SC, et al. Maternal mental health and pediatric health care use among a national sample of Medicaid-and SCHIP-insured children. Journal of Behavioral Health Services & Research. 2010;37(4):443–460.

    Article  Google Scholar 

  14. Geier ML, Hills N, Gonzales M, et al. Detection and treatment rates for perinatal depression in a state Medicaid population. CNS Spectrums. 2015;20(1):11–19.

    Article  Google Scholar 

  15. US Preventive Services Task Force. Final Recommendation Statement: Perinatal Depression: Preventive Interventions. https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/perinatal-depression-preventive-interventions. Accessed February 25, 2019.

  16. Accortt EE, Cheadle AC, Schetter CD. Prenatal depression and adverse birth outcomes: an updated systematic review. Maternal and Child Health Journal. 2015;19(6):1306–1337.

    Article  Google Scholar 

  17. Jarde A, Morais M, Kingston D, et al. Neonatal outcomes in women with untreated antenatal depression compared with women without depression: a systematic review and meta-analysis. JAMA Psychiatry. 2016;73(8):826–837.

    Article  Google Scholar 

  18. Field T, Diego M, Hernandez-Reif M. Prenatal depression effects on the fetus and newborn: a review. Infant Behavior and Development. 2006;29(3):445–455.

    Article  Google Scholar 

  19. O’Hara MW, McCabe JE. Postpartum depression: current status and future directions. Annual Review of Clinical Psychology. 2013;9:379–407.

    Article  Google Scholar 

  20. Lampard AM, Franckle RL, Davison KK. Maternal depression and childhood obesity: a systematic review. Preventive Medicine. 2014;59:60–67.

    Article  Google Scholar 

  21. Liu CH, Tronick E. Rates and predictors of postpartum depression by race and ethnicity: results from the 2004 to 2007 New York City PRAMS survey (Pregnancy Risk Assessment Monitoring System). Maternal and Child Health Journal. 2013;17(9):1599–1610.

    Article  Google Scholar 

  22. Coates AO, Schaefer CA, Alexander JL. Detection of postpartum depression and anxiety in a large health plan. Journal of Behavioral Health Services & Research. 2004;31(2):117–133.

    Article  Google Scholar 

  23. Rising SS. Centering Pregnancy: An Interdisciplinary Model of Empowerment. Journal of Nurse-Midwifery. 1998;43(1):46–54. https://doi.org/10.1016/S0091-2182(97)00117-1

    Article  CAS  PubMed  Google Scholar 

  24. Hill I, Benatar S, Courtot B, et al. Strong start for mothers and newborns evaluation: year 4 annual report. Washington, D.C.: Urban Institute. https://downloads.cms.gov/files/cmmi/strongstart-prenatal-finalevalrpt-v1.pdf.

  25. Markus AR, Andres E, West KD, et al. Medicaid covered births, 2008 through 2010, in the context of the implementation of health reform. Womens Health Issues. 2013;23(5):e273–e280.

    Article  Google Scholar 

  26. Hill I, Dubay L, and Courtot B, et al. 2018. Strong Start for Mothers and Newborns Evaluation. Urban Institute, Washington, D.C. https://downloads.cms.gov/files/cmmi/strongstart-prenatal-finalevalrpt-v1.pdf.

  27. Björgvinsson T, Kertz SJ, Bigda-Peyton JS, et al. Psychometric properties of the CES-D-10 in a psychiatric sample. Assessment. 2013;20(4):429–436.

    Article  Google Scholar 

  28. Blumenshine P, Egerter S, Barclay CJ, et al. Socioeconomic disparities in adverse birth outcomes: a systematic review. American Journal of Preventive Medicine. 2010;39(3):263–272.

    Article  Google Scholar 

  29. McGrady GA, Sung JF, Rowley DL, et al. Preterm delivery and low birth weight among first-born infants of black and white college graduates. American Journal of Epidemiology. 1992;136(3):266–276.

    Article  CAS  Google Scholar 

  30. Bishop TF, Press MJ, Keyhani S, et al. Acceptance of insurance by psychiatrists and the implications for access to mental health care. JAMA Psychiatry. 2014;71(2):176–181.

    Article  Google Scholar 

  31. Cummings JR, Wen H, Ko M, et al. Geography and the Medicaid mental health care infrastructure: implications for health care reform. JAMA Psychiatry. 2013;70(10):1084–1090.

    Article  Google Scholar 

  32. Access to Care: Provider Availability in Medicaid Managed Care (OEI-02-13-00670). Washington, D.C.: Department of Health and Human Services, Office of the Inspector General; 2014. https://oig.hhs.gov/oei/reports/oei-02-13-00670.asp. Accessed July 31, 2018.

  33. Weinreb L, Byatt N, Simas TAM, et al. What happens to mental health treatment during pregnancy? Women’s experience with prescribing providers. Psychiatric Quarterly. 2014;85(3):349–355.

    Article  Google Scholar 

  34. Teh CF, Sorbero MJ, Mihalyo MJ, et al. Predictors of adequate depression treatment among Medicaid-enrolled adults. Health Services Research. 2010;45(1):302–315.

    Article  Google Scholar 

  35. Gjerdingen DK, Yawn BP. Postpartum depression screening: importance, methods, barriers, and recommendations for practice. Journal of the American Board of Family Medicine. 2007;20(3):280–288.

    Article  Google Scholar 

  36. Joseph JG, El-Mohandes AA, Kiely M, et al. Reducing psychosocial and behavioral pregnancy risk factors: results of a randomized clinical trial among high-risk pregnant African American women. American Journal of Public Health. 2009;99(6):1053–1061.

    Article  Google Scholar 

  37. Smith MV, Shao L, Howell H, et al. Success of mental health referral among pregnant and postpartum women with psychiatric distress. General Hospital Psychiatry. 2009;31(2):155–162.

    Article  Google Scholar 

  38. Lancaster CA, Gold KJ, Flynn HA, et al. Risk factors for depressive symptoms during pregnancy: a systematic review. American Journal of Obstetrics and Gynecology. 2010;202(1):5–14. https://doi.org/10.1016/j.ajog.2009.09.007

    Article  PubMed  PubMed Central  Google Scholar 

  39. Kaiser Family Foundation. Births Financed by Medicaid. https://www.kff.org/medicaid/state-indicator/births-financed-by-medicaid/. Published October 13, 2016. Accessed July 31, 2018.

  40. Goyal D, Gay C, Lee KA. How much does low socioeconomic status increase the risk of prenatal and postpartum depressive symptoms in first-time mothers? Womens Health Issues. 2010;20(2):96–104.

    Article  Google Scholar 

  41. Zabkiewicz D. The mental health benefits of work: do they apply to poor single mothers? Social Psychiatry and Psychiatric Epidemiology. 2010;45(1):77–87.

    Article  Google Scholar 

  42. Edin K, Kissane RJ. Poverty and the American family: A decade in review. Journal of Marriage and Family. 2010;72(3):460–479.

    Article  Google Scholar 

  43. Butterworth P, Leach LS, McManus S, et al. Common mental disorders, unemployment and psychosocial job quality: is a poor job better than no job at all? Psychological Medicine. 2013;43(8):1763–1772.

    Article  CAS  Google Scholar 

  44. Woods SM, Melville JL, Guo Y, et al. Psychosocial stress during pregnancy. American Journal of Obstetrics and Gynecology. 2010;202(1):61.e1-61.e7. https://doi.org/10.1016/j.ajog.2009.07.041

    Article  Google Scholar 

  45. Centers for Disease Control and Prevention. Preterm Birth. https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pretermbirth.htm. Published 2019. Accessed October 28, 2019.

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Authors and Affiliations

  1. Urban Institute, Washington, DC, USA

    Sarah Benatar, Emily Johnston & Ian Hill

  2. Center for Medicare and Medicaid Innovation, Baltimore, Maryland, USA

    Caitlin Cross-Barnet

Authors
  1. Sarah Benatar
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  2. Caitlin Cross-Barnet
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  3. Emily Johnston
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  4. Ian Hill
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Correspondence to Sarah Benatar.

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Benatar, S., Cross-Barnet, C., Johnston, E. et al. Prenatal Depression: Assessment and Outcomes among Medicaid Participants. J Behav Health Serv Res 47, 409–423 (2020). https://doi.org/10.1007/s11414-020-09689-2

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