Abstract：
UNASSIGNED: This study quantified the prevalence of postpartum mood and anxiety disorder (PMAD) diagnoses among symptomatic Michigan Medicaid enrollees and explored factors associated with receiving a diagnosis.
UNASSIGNED: Data sources comprised Michigan Medicaid administrative claims and Phase 7 Michigan Pregnancy Risk Assessment Monitoring System (MI-PRAMS) survey responses, linked at the individual level. Participants were continuously enrolled in Michigan Medicaid, delivered a live birth (2012-2015), responded to the survey, and screened positive for PMAD symptoms on the adapted two-item Patient Health Questionnaire. Unadjusted and adjusted weighted logistic regression analyses were used to predict the likelihood of having a PMAD diagnosis (for the overall sample and stratified by race).
UNASSIGNED: The weighted analytic cohort represented 24,353 deliveries across the 4-year study. Only 19.8% of respondents with symptoms of PMAD had a PMAD diagnosis between delivery and 3 months afterward. Black respondents were less likely to have PMAD diagnoses (adjusted odds ratio [AOR]=0.23, 95% CI=0.11-0.49) compared with White respondents. Among White respondents, no covariates were significantly associated with having a diagnosis. However, among Black respondents, more comorbid conditions and more life stressors were statistically significantly associated with having a diagnosis (AOR=3.18, 95% CI=1.27-7.96 and AOR=3.12, 95% CI=1.10-8.88, respectively).
UNASSIGNED: Rate of PMAD diagnosis receipt differed by race and was low overall. Black respondents were less likely than White respondents to receive a diagnosis. Patient characteristics influencing diagnosis receipt also differed by race, indicating that strategies to improve detection of these disorders require a tailored approach.
UNASSIGNED: Data sources comprised Michigan Medicaid administrative claims and Phase 7 Michigan Pregnancy Risk Assessment Monitoring System (MI-PRAMS) survey responses, linked at the individual level. Participants were continuously enrolled in Michigan Medicaid, delivered a live birth (2012-2015), responded to the survey, and screened positive for PMAD symptoms on the adapted two-item Patient Health Questionnaire. Unadjusted and adjusted weighted logistic regression analyses were used to predict the likelihood of having a PMAD diagnosis (for the overall sample and stratified by race).
UNASSIGNED: The weighted analytic cohort represented 24,353 deliveries across the 4-year study. Only 19.8% of respondents with symptoms of PMAD had a PMAD diagnosis between delivery and 3 months afterward. Black respondents were less likely to have PMAD diagnoses (adjusted odds ratio [AOR]=0.23, 95% CI=0.11-0.49) compared with White respondents. Among White respondents, no covariates were significantly associated with having a diagnosis. However, among Black respondents, more comorbid conditions and more life stressors were statistically significantly associated with having a diagnosis (AOR=3.18, 95% CI=1.27-7.96 and AOR=3.12, 95% CI=1.10-8.88, respectively).
UNASSIGNED: Rate of PMAD diagnosis receipt differed by race and was low overall. Black respondents were less likely than White respondents to receive a diagnosis. Patient characteristics influencing diagnosis receipt also differed by race, indicating that strategies to improve detection of these disorders require a tailored approach.
摘要：
■这项研究量化了有症状的密歇根医疗补助参与者中产后情绪和焦虑障碍（PMAD）诊断的患病率，并探讨了与接受诊断相关的因素。
■数据来源包括密歇根州医疗补助行政索赔和7期密歇根州妊娠风险评估监测系统（MI-PRAMS）调查答复。联系在个人层面。参与者连续参加密歇根医疗补助，分娩活产(2012-2015)，对调查的回应，并在适应的两项患者健康问卷中筛选出PMAD症状阳性。使用未调整和调整的加权逻辑回归分析来预测具有PMAD诊断的可能性(对于总体样本和按种族分层)。
■加权分析队列代表了4年研究中的24,353例分娩。只有19.8%的有PMAD症状的受访者在分娩至3个月后有PMAD诊断。与白人受访者相比，黑人受访者不太可能有PMAD诊断（调整后比值比[AOR]=0.23，95％CI=0.11-0.49）。在白人受访者中，没有协变量与诊断显著相关.然而,在黑人受访者中，更多的合并症和更多的生活压力源与诊断有统计学显著相关(分别为AOR=3.18,95%CI=1.27-7.96和AOR=3.12,95%CI=1.10-8.88).
■PMAD诊断接诊率因种族而异，总体较低。黑人受访者比白人受访者不太可能接受诊断。影响诊断接收的患者特征也因种族而异，这表明改善这些疾病检测的策略需要量身定制的方法。
■数据来源包括密歇根州医疗补助行政索赔和7期密歇根州妊娠风险评估监测系统（MI-PRAMS）调查答复。联系在个人层面。参与者连续参加密歇根医疗补助，分娩活产(2012-2015)，对调查的回应，并在适应的两项患者健康问卷中筛选出PMAD症状阳性。使用未调整和调整的加权逻辑回归分析来预测具有PMAD诊断的可能性(对于总体样本和按种族分层)。
■加权分析队列代表了4年研究中的24,353例分娩。只有19.8%的有PMAD症状的受访者在分娩至3个月后有PMAD诊断。与白人受访者相比，黑人受访者不太可能有PMAD诊断（调整后比值比[AOR]=0.23，95％CI=0.11-0.49）。在白人受访者中，没有协变量与诊断显著相关.然而,在黑人受访者中，更多的合并症和更多的生活压力源与诊断有统计学显著相关(分别为AOR=3.18,95%CI=1.27-7.96和AOR=3.12,95%CI=1.10-8.88).
■PMAD诊断接诊率因种族而异，总体较低。黑人受访者比白人受访者不太可能接受诊断。影响诊断接收的患者特征也因种族而异，这表明改善这些疾病检测的策略需要量身定制的方法。
