Incidence of Postpartum Mental and Behavioral Disorders in Japan
ISPOR EU 2023
Milliman, Inc., Tokyo, Japan
Chise Ha¹, Tomomi Takeshima¹, Yumi Sato², Ikumi Nishi², Shinzo Hiroi², Takumi Sugiyama³, Gen Terashima³, Akiko Hatakama⁴, Ataru Igarashi⁵,⁶
1 )Milliman, Inc., Tokyo, Japan
2 )Shionogi & Co., Ltd., Tokyo, Japan
3 )JMDC Inc, Tokyo, Japan
4 )DeSC Healthcare, Tokyo, Japan
5 )The University of Tokyo, Tokyo, Japan.
6 )Yokohama City University, Kanagawa, Japan.
Postpartum depression (PPD) develops in a critical stage of a woman’s life and thelikelihood of depressive symptoms could be twice as high as other periods of life. PPD is often leftuntreated and can continue for a long time. Negative impacts are expected on the subsequent familyplanning and the parenting behavior of the affected family. Thus, we assessed the incidence ofpostpartum mental and behavioral disorders, which can accelerate the already-falling birthrate inJapan.
DeSC database including data of employee-based health insurance (EHI) for employeesand their families and the citizens’ health insurance (NHI) for non-/self-employed workers was used.Since eutocia is not covered by the compulsory insurance and cannot be directly identified with claims,a childbirth was identified if a woman aged 15
49 years at childbirth had a matched ID with a newbornfrom April 2014 through May 2022. The cumulative incidence rate (CIR) of mental and behavioraldisorders (F00
F99) were compared between the birth group and the non-birth control matched forsex, birthday month, insurance type, and the first and last month of the observable period usingLogrank test. The monthly incidence from childbirth was also examined.
The birth group included 23,236 women (29% NHI, 3% EHI, 69% EHI as family members). TheCIR was significantly higher in the birth group (p<0.0001). A total of 4,917 women developed mentaland behavioral disorders in the birth group. The incidence was smaller during six months antepartumand larger during three months postpartum.
The incidence of mental and behavioral disorders was higher after the childbirth thanbefore, suggesting the importance to pay attention to maternal mental health especially during threemonths after the childbirth even if no signs of PPD were observed before the childbirth.