The Association between NICU Admission and Mental Health Diagnoses among Commercially Insured Postpartum Women in the US, 2010–2018

Maternal mental health (MH) conditions represent a leading cause of preventable maternal death in the US. Neonatal Intensive Care Unit (NICU) hospitalization influences MH symptoms among postpartum women, but a paucity of research uses national samples to explore this relationship. Using national ad...

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Bibliographic Details
Main Authors: Dana C. Beck, Karen M. Tabb, Anca Tilea, Stephanie V. Hall, Ashlee Vance, Stephen W. Patrick, Amy Schroeder, Kara Zivin
Format: Article
Language:English
Published: MDPI AG 2022-10-01
Series:Children
Subjects:
Online Access:https://www.mdpi.com/2227-9067/9/10/1550
Description
Summary:Maternal mental health (MH) conditions represent a leading cause of preventable maternal death in the US. Neonatal Intensive Care Unit (NICU) hospitalization influences MH symptoms among postpartum women, but a paucity of research uses national samples to explore this relationship. Using national administrative data, we examined the rates of MH diagnoses of anxiety and/or depression among those with and without an infant admitted to a NICU between 2010 and 2018. Using generalized estimating equation models, we explored the relationship between NICU admission and MH diagnoses of anxiety and/or depression, secondarily examining the association of NICU length of stay and race/ethnicity with MH diagnoses of anxiety and/or depression post NICU admission. Women whose infants became hospitalized in the NICU for <2 weeks had 19% higher odds of maternal MH diagnoses (aOR: 1.19, 95% CI: 1.14%–1.24%) and those whose infants became hospitalized for >2 weeks had 37% higher odds of maternal MH diagnoses (aOR: 1.37 95% CI: 1.128%–1.47%) compared to those whose infants did not have a NICU hospitalization. In adjusted analyses, compared to white women, all other race/ethnicities had significantly lower odds of receiving a maternal MH condition diagnosis [Black (aOR = 0.76, 0.73–0.08), Hispanic (aOR = 0.69, 0.67–0.72), and Asian (aOR: 0.32, 0.30–0.34)], despite higher rates of NICU hospitalization. These findings suggest a need to target the NICU to improve maternal MH screening, services, and support while acknowledging the influence of social determinants, including race and ethnicity, on health outcomes.
ISSN:2227-9067