Table 2.
Psychiatric treatment patterns among veterans with active post-traumatic stress disorder (PTSD) whose pregnancy care was reimbursed by the Veterans Health Administration, 2005-2015.
| Treatment | Whole Cohort N=3,242 N (%)a |
Term birth ≥37 weeks N=2,993 |
Spontaneous preterm birth <37 weeks N=249 |
P-valueb |
|---|---|---|---|---|
| Any treatment within 12 months prior to childbirthc | 2,564 (79.1) | 2,356 (78.7) | 208 (83.5) | 0.07 |
| Any psychotropic medication within 12 months prior to childbirthd | 2,011 (62.0) | 1,837 (61.4) | 174 (69.9) | 0.01 |
| Any clinical visit for medication managemente | 1,907 (58.8) | 1,742 (58.2) | 165 (66.3) | 0.01 |
| Type of psychotropic medication dispensedd |
||||
| Antidepressant | 1,769 (54.6) | 1,606 (53.7) | 163 (65.5) | <0.001 |
| Benzodiazepine | 419 (12.9) | 380 (12.7) | 39 (15.7) | 0.18 |
| Antipsychotic | 381 (11.8) | 340 (11.4) | 41 (16.5) | 0.02 |
| Tri-cyclic antidepressant | 137 (4.2) | 121 (4.0) | 16 (6.4) | 0.07 |
| Sedative | 461 (14.2) | 419 (14.0) | 42 (16.9) | 0.21 |
| Number of antidepressant medication dispensations during pregnancyd | <0.001 | |||
| 0 | 1,473 (45.4) | 1,387 (46.3) | 86 (34.5) | |
| 1-2 | 737 (22.7) | 669 (22.4) | 68 (27.3) | |
| 3-5 | 616 (19.0) | 569 (19.0) | 47 (18.9) | |
| ≥6 | 416 (12.8) | 368 (12.3) | 48 (19.3) | |
| ≥1 opioid dispensation within 12 months prior to childbirth | 673 (20.8) | 607 (20.3) | 66 (26.5) | 0.02 |
| Number of unique medication categories used | 0.02 | |||
| Monotherapy (1 medication type) | 1,188 (36.6) | 1,097 (36.7) | 91 (36.5) | |
| Polytherapy (>1 medication type) | 911 (28.1) | 815 (27.2) | 96 (38.6) | |
| Any psychotherapy visit in 12 months prior to childbirthe |
1,768 (54.5) | 1,621 (54.2) | 147 (59.0) | 0.14 |
| 0 sessions | 1,474 (45.5) | 1,372 (45.8) | 102 (41.0) | |
| 1-7 sessions | 1,300 (40.1) | 1,195 (39.9) | 105 (42.2) | 0.27 |
| ≥8 sessions | 468 (14.4) | 426 (14.2) | 42 (16.9) | |
| Stopped medications 12 months childbirth | 332 (10.2) | 306 (10.2) | 26 (10.4) | 0.91 |
| Stopped therapy 12 months prior to childbirth | 525 (16.2) | 492 (16.4) | 33 (13.3) | 0.19 |
a
Listed as column N (%) or median (Q1,Q3) unless otherwise specified.
b
Wilcoxon rank sum, Fisher or Chi where appropriate. P-values ≥0.01 listed to one-hundredth decimal place, p-values <0.01 listed to one-thousandth decimal place.
c
Any psychotropic medication dispensation or therapy visit within 12 months prior to childbirth.
d
1 or more fills of at least a 7-day supply of any included psychotropic prescription in the 12 months prior to childbirth.
e
Multiple visits in a single day were counted as 1 visit. Includes any visit within 12 months prior to childbirth.