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National trends in antidepressant medication treatment among publicly insured pregnant women
Open accessAbstract
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.
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“Although pharmacological treatment is effective and can be safely utilized during pregnancy under medical supervision, only 2–8% of pregnant women are currently estimated to use antidepressants (23–26).”
From Acceptance, experiences, and needs of hospitalized pregnant women toward an electronic mindfulness-based intervention: A pilot mixed-methods study (2022) · cites this paper as [26]
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Metadata
- Authors
- Huybrechts, K. F., Palmsten, K., Mogun, H., Kowal, M., Avorn, J., Setoguchi-Iwata, S., & Hernández-Díaz, S.
- Affiliations
- Brigham and Women's Hospital (US)
- Harvard University (US)
- Duke University (US)
- Corresponding author
- Huybrechts, Krista F.
- Venue
- General Hospital Psychiatry
- Publisher
- Elsevier BV
- Published
- 2013-05
- Volume
- 35
- Issue
- 3
- Pages
- 265-271
- ISSN
- 0163-8343 (ISSN-L)
- PMC
- PMC4077674
- OpenAlex
- W2114602840
- Cited by
- 161
- References
- 38
- Citations by year
- 2026: 2 · 2025: 10 · 2024: 8 · 2023: 10 · 2022: 14 · 2021: 13 · 2020: 19 · 2019: 16 · 2018: 16 · 2017: 14 · 2016: 11 · 2015: 12 · 2014: 12 · 2013: 3
- FWCI
- 12.92
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- General Hospital Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Child Health and Human Development
- National Institutes of Health
- Agency for Healthcare Research and Quality (T32HD060454, R01 HSO18533)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Keywords
- antidepressant use in pregnancy, maternal depression, Medicaid, regional variation in treatment, racial disparities, temporal trends
- MeSH terms
- Adolescent, Adult, Antidepressive Agents, Child, Depressive Disorder, Female, Humans, Medicaid, Middle Aged, Pregnancy, Pregnancy Complications, United States, Cohort Studies, Young Adult
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