Psychiatric Conditions During the Prenatal and Postpartum Period in the TRICARE Population: 2019–2023

Abstract

Background:

Psychiatric conditions among women during pregnancy and postpartum can seriously impact the mother, child, and family. Building upon previous studies, we evaluated the incidence of psychiatric conditions during pregnancy and one year postpartum between fiscal years (FY) 2019 and 2023 in beneficiaries of the U.S. Military Health System (MHS), which provides universal access.

Materials and Methods:

Retrospective cohort study of female TRICARE beneficiaries ages 15–49 who delivered a baby between FY 2019 and 2023 utilizing claims data from the MHS Data Repository to identify deliveries and mental health conditions. Multivariable logistic regression was used to determine patient likelihood of having an incident psychiatric condition during pregnancy and postpartum.

Results:

We identified 200,623 deliveries from FY 2019 to 2023, including 43,625 (21.7%) where the mother had an incident psychiatric condition, of which 18,560 (9.2%) were during pregnancy and 25,065 (12.5%) were within a year of delivery. Compared with their referent groups, women who were more likely to have an incident psychiatric condition included those ages 15–24, of active duty status, and unmarried. Mothers with hypertension, diabetes, severe maternal morbidity, and preterm delivery were more likely to have an incident psychiatric condition.

Discussion:

This study found that more than one in five deliveries in the MHS were associated with an incident psychiatric condition during pregnancy or one year postpartum. Incidence of psychiatric conditions in women receiving care in the MHS was comparable with the American population. Despite universal access to care, variations in patient likelihood of having psychiatric conditions across different characteristics were observed.