Identifying Pregnant and Postpartum Women with Mental Health and Substance Abuse Disorders using Linked Hospital Visit Data

Few state population data are available about mental health and substance abuse among pregnant and postpartum women. Our study objectives were to identify women with mental health or substance abuse (MH/SA) diagnoses noted when they sought hospital care during pregnancy and the postpartum period and to identify disparities by age, race/ethnicity, payer, and martial status. Methods: We used a maternally linked longitudinal data file containing birth and fetal death certificates and hospitals visits (inpatient, emergency and observation stay) during pregnancy and the postpartum period for all Massachusetts women who delivered in 2002 and 2003 (N= 176,897 deliveries). Applying the AHRQ HCUP Mental Health and Substance Abuse Clinical Classifications Software (CCS-MHSA) tool, we identified hospital visits with ICD-9 codes for MH/SA. We compared the unadjusted and adjusted relative risks by demographic characteristics for women with a MH/SA diagnosis at a hospital visit compared with the population as a whole. Results: Over 6.5% (11,464) of women had a hospital visit with a MH/SA diagnosis. In 25% of the 17,462 visits with a MH/SA diagnosis, the MH/SA disorder was the primary diagnosis. The unadjusted risk for a visit with an MH/SA diagnosis was increased for women who were Hispanic, Black non-Hispanic, under age 25, unmarried, and with a high school education. Adjusted and other results will also be presented. Conclusions: MH/SA was a common morbidity identified during hospital visits to pregnant and postpartum women in Massachusetts but rate was not equal for all women.