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2008-2020 年商业保险分娩妇女围产期注意缺陷多动障碍诊断率。

Perinatal attention-deficit/hyperactivity disorder diagnosis rates among commercially insured delivering women 2008-2020.

机构信息

Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, United States of America.

Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI, United States of America; Program on Women's Healthcare Effectiveness Research, Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI, United States of America.

出版信息

J Affect Disord. 2024 Nov 15;365:36-40. doi: 10.1016/j.jad.2024.08.073. Epub 2024 Aug 13.

Abstract

OBJECTIVES

Cognitive impairment and decreased executing functioning represent common symptoms of both ADHD and pregnancy. This study aimed to characterize temporal trends and racial/ethnic disparities in ADHD diagnosis during the perinatal period.

METHODS

In this serial cross-sectional study, we used administrative claims to create a cohort of commercially insured women with a documented live birth between 2008 and 2020 and identified those with an ADHD diagnosis in the year before or after delivery. We applied logistic regression to assess the probability of ADHD diagnosis adjusting for race/ethnicity, age, and comorbid conditions. We used this model to calculate the predicted probability of ADHD diagnosis by racial/ethnic group for each year.

RESULTS

We identified 736,325 deliveries from 2008 to 2020. Overall, 16,801 (2.28 %) of deliveries had an ADHD diagnosis in the year before or after delivery. ADHD rates increased 290 % from 101 (95%CI: 92-111) per 10,000 deliveries in 2008 to 394 (95%CI: 371-419) per 10,000 deliveries in 2020. White women experienced the highest rates followed by Black, Hispanic, and Asian, respectively.

CONCLUSIONS

Increasing ADHD diagnosis rates during the perinatal period may reflect improved detection but racial disparities persist. Additional research is needed to develop equitable outreach strategies to better support women experiencing ADHD during the perinatal period.

摘要

目的

认知障碍和执行功能下降是 ADHD 和怀孕的常见症状。本研究旨在描述围产期 ADHD 诊断的时间趋势和种族/民族差异。

方法

在这项连续的横断面研究中,我们使用行政索赔创建了一个记录在案的活产于 2008 年至 2020 年之间的商业保险妇女队列,并在分娩前或分娩后一年内确定了 ADHD 诊断的妇女。我们应用逻辑回归来评估调整种族/民族、年龄和合并症后 ADHD 诊断的概率。我们使用该模型计算了每个种族/民族组在每年的 ADHD 诊断预测概率。

结果

我们从 2008 年至 2020 年确定了 736325 次分娩。总体而言,16801(2.28%)次分娩在分娩前或分娩后一年内有 ADHD 诊断。ADHD 发病率从 2008 年的每 10000 次分娩 101 例(95%CI:92-111)增加到 2020 年的每 10000 次分娩 394 例(95%CI:371-419),增加了 290%。白人女性的发病率最高,其次是黑人、西班牙裔和亚裔。

结论

围产期 ADHD 诊断率的增加可能反映了检测水平的提高,但种族差异仍然存在。需要进一步研究,制定公平的外展策略,以更好地支持围产期患有 ADHD 的妇女。

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