The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #71069

Selvi B. Williams, MD¹, Evelyn P. Whitlock, MD, MPH², Lynn L. DeBar, PhD, MPH², Linda Chaudron, MD, MS³, Don Bachman, MS², and Mark C. Hornbrook, PhD². (1) Public Health and Preventive Medicine, Oregon Health and Science University, 3181 S.W. Sam Jackson Park Road, CB 669, Portland, OR 97201-3098, 503-494-8257, willisel@ohsu.edu, (2) Economic, Social, and Health Services Research Program, Kaiser Permanente Center for Health Research, 3800 North Interstate Avenue, Portland, OR 97227-1098, (3) Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Blvd., Rochester, NY 14642-8409

Unipolar major depression is the leading cause of disease burden in women worldwide. Depression during pregnancy is a strong predictor of postpartum depression and is also associated with increased rates of spontaneous preterm birth. Although 10-16% of pregnant women meet criteria for major depression, little data exist about actual diagnosis and treatment patterns in clinical practice. It is hypothesized that medical disorders which contribute to depressive symptoms such as thyroid dysfunction, anemia, and gestational diabetes, may not be well-assessed in these women. The Kaiser Permanente Center for Health Research in Portland, OR has access to computerized medical and pharmacy records of members of the Kaiser Permanente Northwest health maintenance organization population ( ~ 450,000). Researchers are currently conducting a study in collaboration with the CDC evaluating maternal morbidities in approximately 30,000 pregnant females aged 12 to 55 years from 1998 to 2001. This presentation will report the prevalence of depression diagnosis in this cohort of pregnant women using ICD-9 codes from an electronic medical record and administrative databases. We will link this information with laboratory and pharmacy data in order to describe the medical evaluation and pharmacologic treatment patterns for women with antenatal depression. Optimal management of depression during pregnancy could lead to lower rates of postpartum depression and preterm birth which would be beneficial for both women and their infants.

Learning Objectives:

• Describe the nature of depression during pregnancy as well as its potential etiologies and health consequences
• Evaluate current patterns of antepartum depression diagnosis including the use of appropriate laboratory evaluation
• Analyze current treatment patterns of antenatal depression in a large managed care setting

Keywords: Depression, Pregnancy

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.