Financial Toll of Untreated Perinatal Mood and Anxiety Disorders Among 2017 Births in the United States

Luca, Dara Lee; Margiotta, Caroline; Staatz, Colleen; Garlow, Eleanor; Christensen, Anna L.; Zivin, Kara

doi:10.2105/ajph.2020.305619

Cited by 197 publications

(151 citation statements)

References 59 publications

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“…Perinatal anxiety rates were approximately six times higher in this sample compared to pre-pandemic perinatal rates in Colorado. 29 Additionally, participants reported lower well-being 30 and lower levels of resilience compared to pre-pandemic scores. 26 The qualitative component of this study illustrated sources of stress that further explain these quantitative findings.…”

Section: Discussionmentioning

confidence: 99%

A Mixed-Methods Pilot Study of Perinatal Risk and Resilience During COVID-19

Farewell

Jewell

Walls

et al. 2020

J Prim Care Community Health

166

189

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Introduction/Objectives: National guidelines underscore the need for improvement in the detection and treatment of mood disorders in the perinatal period. Exposure to disasters can amplify perinatal mood disorders and even have intergenerational impacts. The primary aim of this pilot study was to use mixed-methods to better understand the mental health and well-being effects of the coronavirus disease 2019 (COVID-19) pandemic, as well as sources of resilience, among women during the perinatal period. Methods: The study team used a simultaneous exploratory mixed-methods design to investigate the primary objective. Thirty-one pregnant and postpartum women participated in phone interviews and were invited to complete an online survey which included validated mental health and well-being measures. Results: Approximately 12% of the sample reported high depressive symptomatology and 60% reported moderate or severe anxiety. Forty percent of the sample reported being lonely. The primary themes related to stress were uncertainty surrounding perinatal care, exposure risk for both mother and baby, inconsistent messaging from information sources and lack of support networks. Participants identified various sources of resilience, including the use of virtual communication platforms, engaging in self-care behaviors (eg, adequate sleep, physical activity, and healthy eating), partner emotional support, being outdoors, gratitude, and adhering to structures and routines. Conclusions: Since the onset of COVID-19, many pregnant and postpartum women report struggling with stress, depression, and anxiety symptomatology. Findings from this pilot study begin to inform future intervention work to best support this highly vulnerable population.

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Section: Discussionmentioning

confidence: 99%

A Mixed-Methods Pilot Study of Perinatal Risk and Resilience During COVID-19

Farewell

Jewell

Walls

et al. 2020

J Prim Care Community Health

166

189

View full text Add to dashboard Cite

show abstract

“…They found that it cost $32,000 for each mother‐child dyad that was affected but untreated. In 2017, this cost the United States an estimated $14.2 billion . Sixty percent of these costs were attributed to maternal outcomes and the remaining 40% to child outcomes.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Postpartum Depression: An Umbrella Review

Hutchens

Kearney

2020

J Midwife Womens Health

228

134

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Introduction: A deeper understanding of risk factors for postpartum depression (PPD) is essential to better target prevention and screening. An umbrella review was conducted to summarize and synthesize previously published systematic reviews and meta-analyses. Methods: Eight databases were searched in October of 2016, including PubMed, CINAHL, MEDLINE, PsycINFO, Embase, SCOPUS, PsycEX-TRA, and Cochrane. Studies were included if they were reviews examining one or more risk factors for PPD and published between 1996 and 2016. The final sample included 21 articles, which varied in numerous ways, including the scope of risk factors explored and statistical methods. Results: Because of methodological variations between reviews, standardized statistical aggregation was not possible. From this body of literature, 25 statistically significant risk factors emerged with 2 additional risk factors presenting inconclusive findings. The most common risk factors identified were high life stress, lack of social support, current or past abuse, prenatal depression, and marital or partner dissatisfaction. The 2 strongest risk factors for PPD were prenatal depression and current abuse. Discussion: Because untreated PPD leaves women and their children vulnerable to numerous negative short-term and long-term outcomes, a better understanding of PPD risk factors serves to improve maternal and child outcomes by allowing health care providers to better anticipate the needs of affected women.

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“…Our findings represent a unique contribution to the evidence base on the burden of PPD since healthcare costs attributed to PPD have not been previously studied in a comprehensive manner, especially those that might be attributed to the partner and other dependent children in the household. Recent literature has noted that the economic burden of perinatal mood and anxiety disorders in the US was high 25 , however like other studies 24 , was limited to only mother and child economic outcomes. Including household cost comparisons widens the perspective of the large economic PPD incurs and will help inform future cost estimates and analyses.…”

Section: Discussionmentioning

confidence: 91%

“…While the individual and familial psychosocial and developmental consequences of PPD are clear, there is currently limited information about the economic impact of PPD. A recent research based on a cost-of-illness model found that the economic burden of perinatal mood and anxiety disorders in the US was high, with untreated disorders costing about $14 billion for the 2017 birth cohort from conception to 5 years postpartum 25 . While this research combined published estimates of direct healthcare costs and indirect societal costs, it focused only on longer term economic burden of untreated perinatal mood and anxiety disorders.…”

Section: Introductionmentioning

confidence: 99%

Healthcare resource utilization and costs associated with postpartum depression among commercially insured households

Epperson

Huang

Cook

et al. 2020

Current Medical Research and Opinion

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Objective: To quantify the economic burden of postpartum depression (PPD) that accrues to commercially insured households in the year following childbirth. Methods: Administrative claims data from OptumHealth Care Solutions (2009-2016) were used to identify households that included women identified with PPD per the algorithm and propensity score-matched comparison households of women who were not identified with PPD or a history of depression after childbirth. Study outcomes included direct total all-cause medical and pharmaceutical costs during the first year following childbirth and number of outpatient visits at the household level stratified by household member. Results: Households affected by PPD as identified by the algorithm (N ¼ 7769) incurred 22% higher mean total all-cause medical and pharmaceutical spending than unaffected matched controls (N ¼ 41,308) during the first year following childbirth ($36,049 versus $29,448, p < 0.01) and an average of 16 more outpatient visits than unaffected households (p < .01). Costs accrued by mothers comprised the largest share (>50%) of total all-cause spending. Mothers identified with PPD had significantly higher annual mean direct total all-cause medical and pharmaceutical spending than their matched controls without PPD ($19,611 versus $15,410, p < .01), driven primarily by an average of 11 more outpatient visits than unaffected mothers (p < .01). Conclusions: Households affected by PPD as identified by the algorithm incurred higher mean total all-cause medical and pharmaceutical spending during the first year following childbirth than did their matched controls identified without PPD, but not all costs were attributable to maternal treatment for PPD. These findings contribute to a better understanding of the potential economic burden associated with PPD and demonstrated costs may extend beyond the mother to members of the household.

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Financial Toll of Untreated Perinatal Mood and Anxiety Disorders Among 2017 Births in the United States

Cited by 197 publications

References 59 publications

A Mixed-Methods Pilot Study of Perinatal Risk and Resilience During COVID-19

A Mixed-Methods Pilot Study of Perinatal Risk and Resilience During COVID-19

Risk Factors for Postpartum Depression: An Umbrella Review

Healthcare resource utilization and costs associated with postpartum depression among commercially insured households

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