Trends in postpartum mental health care before and during COVID-19

Health Serv Res. 2022 Dec;57(6):1342-1347. doi: 10.1111/1475-6773.14051. Epub 2022 Sep 4.

Abstract

Objective: To assess the impact of COVID-19 on trends in postpartum mental health diagnoses and utilization of psychotherapy and prescription drug treatment.

Data sources: Data were obtained from a large, national health insurance claims database that tracks individuals longitudinally.

Study design: We used interrupted time series models to examine changes in trends of postpartum mental health diagnoses before and during the COVID-19 pandemic and t-tests to examine differences in treatment.

Data extraction methods: We used billing codes to identify individuals who received mental health-related diagnoses and treatment in the first 90 days after a birth hospitalization. We excluded individuals diagnosed with schizophrenia or bipolar disorder and those with an unknown payer at delivery.

Principal findings: Compared to the pre-pandemic period, the trend in new postpartum mental health diagnoses increased significantly in the post-COVID-19 period (0.06 percentage points [95%CI 0.01, 0.11]). Over 12 months, the percentage of new diagnoses was 5.0% greater relative to what would be expected in absence of COVID-19. The percentage of diagnosed individuals who did not receive treatment increased from 50.4% to 52.7% (p = 0.003).

Conclusions: Findings point to an urgent need to improve screening and treatment pathways for perinatal individuals in the wake of COVID-19.

Keywords: COVID-19; COVID-19 research database; Medicaid; interrupted time series; mental health; perinatal depression.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Bipolar Disorder*
  • COVID-19* / epidemiology
  • COVID-19* / therapy
  • Female
  • Humans
  • Mental Health
  • Pandemics
  • Postpartum Period
  • Pregnancy