National trends in antidepressant medication treatment among publicly insured pregnant women

Krista F. Huybrechts, Kristin Palmsten, Helen Mogun, Mary Kowal, Jerry Avorn, Soko Setoguchi-Iwata, Sonia Hernández-Díaz

Research output: Contribution to journalArticlepeer-review

97 Scopus citations

Abstract

Objective: The risk of depression in women is greatest at childbearing age. We sought to examine and explain national trends in antidepressant use in pregnant women. Methods: This was a cohort study including pregnant women aged 12-55 who were enrolled in Medicaid during 2000-2007. We examined the proportion of women taking antidepressants during pregnancy by patient characteristics (descriptive), by region (mixed-effects model) and over time (interrupted time series). Results: We identified 1,106,757 pregnancies in 47 states; mean age was 23 years, and 60% were nonwhite. Nearly 1 in 12 used an antidepressant during pregnancy. Use was higher for older (11.2% for age ≥ 30 vs. 7.6% for < 30) and white (14.4% vs. 4.0% for nonwhite) women. There was a four- to fivefold difference in rate of antidepressant use among states. Of the 5.3% of women taking antidepressants at conception, 33% and 17% were still on treatment 90 and 180 days, respectively, into pregnancy; an additional 4% began use during pregnancy. Labeled pregnancy-related health advisories did not appear to affect antidepressant use. Conclusions: Antidepressant use during pregnancy remains high in this population; treatment patterns vary substantially by patient characteristics and region. Comparative safety and effectiveness data to help inform treatment choices are needed in this setting.

Original languageEnglish (US)
Pages (from-to)265-271
Number of pages7
JournalGeneral Hospital Psychiatry
Volume35
Issue number3
DOIs
StatePublished - May 2013
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Psychiatry and Mental health

Keywords

  • Antidepressants
  • Medicaid
  • National cohort
  • Patterns of medication use
  • Pregnancy

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