Impact of the 2015 ACOG Screening Guidelines on Prevalence of Postpartum Depression Among Privately Insured Women [18K]


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Abstract

INTRODUCTION:The American College of Obstetricians and Gynecologists Committee on Obstetric Practice (ACOG) released a Committee Opinion on postpartum depression in 2015 recommending that women be screened at least once during the perinatal period. It is estimated that postpartum depression (PPD) is largely underdiagnosed. Without treatment, PPD can negatively affect the mother and infant. We hypothesized that the 2015 ACOG Committee Opinion led to an increase in postpartum depression diagnosis and prevalence.METHODS:Data from the Truven Health Analytics MarketScan database was used to analyze PPD prevalence in 244,624 privately insured women ages 13-45 both before and after the 2015 ACOG guidelines. A postpartum depression diagnosis was identified as a PPD ICD-9/10 claim code, other depression ICD-9/10 claim code, or an antidepressant prescription code during the first 12 months following delivery. A subgroup analysis including only women without prior mood disorders was also evaluated. IRB committee approval was obtained.RESULTS:Rates of PPD increased after the 2015 guidelines, when controlling for age, year, delivery complications, and geographic region (adjusted odds ratio, 1.04; 95% confidence interval, 1.01-1.07). ACOG guidelines did not significantly increase rates of PPD in a subanalysis of women without prior history of mood disorders (odds ratio, 1.02; 95% confidence interval, 0.98- 1.05).CONCLUSION:This study demonstrates that ACOG guidelines are effective in increasing postpartum depression diagnosis. However, the 2015 guidelines did not impact PPD prevalence in women with no history of prior mood disorders. These findings indicate that national committee guidelines can be effective in addressing the underdiagnosed status of postpartum depression.

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