Patterns of Treatment Utilization Across the Perinatal Period in the Center for Maternal and Infant Outcomes and Research in Translation (COMFORT) Veterans Study.

Background: Women Veterans using Veterans Affairs (VA) maternity care represent a high-risk population owing to the high prevalence of psychiatric disorders, such as depression, anxiety, and posttraumatic stress disorder (PTSD). Given the increased risk of symptom recurrence and/or medication discon...

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Published in:Journal of Women's Health (15409996) Vol. 30; no. 6; pp. 882 - 891
Main Authors: Shivakumar, Geetha, Kroll-Desrosiers, Aimee R., Copeland, Laurel, Anderson, Elizabeth H., Maydon, Amaris, Mattocks, Kristin
Format: research tables/charts Journal Article
Published: Mary Ann Liebert, Inc. Jun2021
Online Access:View this record in EBSCOhost
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      dt: Jun2021
      vid: 30
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      pub: Mary Ann Liebert, Inc.
      place: New Rochelle, New York
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        10.1089/jwh.2020.8435
        150912261
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        atl: Patterns of Treatment Utilization Across the Perinatal Period in the Center for Maternal and Infant Outcomes and Research in Translation (COMFORT) Veterans Study.
      aug:
        au:
          Shivakumar, Geetha
          Kroll-Desrosiers, Aimee R.
          Copeland, Laurel
          Anderson, Elizabeth H.
          Maydon, Amaris
          Mattocks, Kristin
        affil: Mental Health, VA North Texas Health Care System, Dallas, Texas, USA.
      sug:
        subj:
          Perinatal Care
          Veterans
          Mental Health Services
          Health Resource Utilization
          Expectant Mothers
          Human
          United States Department of Veterans Affairs
          Female
          United States
          Psychotherapy
          Antidepressive Agents
          Postnatal Period
          Depression
          Anxiety
          Stress Disorders, Post-Traumatic
          Female
      ab: Background: Women Veterans using Veterans Affairs (VA) maternity care represent a high-risk population owing to the high prevalence of psychiatric disorders, such as depression, anxiety, and posttraumatic stress disorder (PTSD). Given the increased risk of symptom recurrence and/or medication discontinuation during pregnancy, the aim of this study was to understand the relationship between mental health and health care utilization in pregnant Veterans within the Veterans Health Administration (VHA). Materials and Methods: Women with a confirmed pregnancy were recruited from 15 VA sites across the United States. Data sources included diagnosis codes, clinic stop codes for outpatient visits, and 30-day antidepressant prescriptions in the electronic health record. Results: Overall, mental health visits increased slightly from prepregnancy to pregnancy before decreasing in the postpartum period. For women with a prepregnancy diagnosis of depression, anxiety, and/or PTSD, there was an increase in psychotherapy utilization during the pregnancy and postpartum periods, whereas the percentage of women utilizing antidepressants only or antidepressants plus therapy decreased during these same time periods. A small proportion of women with histories of mental health conditions did not utilize mental health care within the VA during pregnancy and postpartum. Conclusions: These results inform our understanding of VA health care utilization patterns in pregnant Veterans, particularly those with a history of depression, PTSD, and/or anxiety. The strong utilization of VA mental health services during this time emphasizes the importance of optimizing the coordination of care between VA mental health providers and community-provided obstetric care to enhance outcomes for both mother and child.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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