Trends in antenatal depression and suicidal ideation diagnoses among commercially insured childbearing individuals in the United States, 2008–2018

Introduction: Antenatal depression and suicidal ideation represent serious pregnancy-related complications, yet comprehensive estimates of the prevalence and predictors of these diagnoses among birthing people remain unclear. Objective: This study aimed to characterize trends in the prevalence of depression and suicidal ideation diagnoses identified among pregnant individuals prior to giving birth. Methods: This study included 536,647 individuals aged 15–44 years continuously enrolled in a single commercial health insurance plan for one year before childbirth from 2008 to 2018. The primary outcomes included depression or suicidal ideation based on identification of the relevant ICD-9 and ICD-10 diagnosis codes during pregnancy. Results: Rates (95 % CIs) of depression increased by 39 % from 540 (520–560) per 10,000 individuals in 2008 to 750 (730–770) per 10,000 individuals in 2018. Suicidal ideation increased by 100 % from 15 (12–18) per 10,000 individuals in 2008 to 44 (39–50) per 10,000 individuals in 2018. Black birthing people experiencing the sharpest proportional increases. Conclusions: The prevalence of depression and suicidal ideation occurring during pregnancy substantially increased over a ten-year period. Further, suicidal ideation diagnosis increased the most for among Black birthing people compared to all groups, resulting in a need for future studies in this area to determine the reasons for an increase in diagnosis and any change in resulting treatment of follow up.