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

• Published in: Journal of affective disorders 2024-11, Vol.365, p.36-40
• Main Authors: Hall, Stephanie V., Pangori, Andrea, Tilea, Anca, Schroeder, Amy, Zivin, Kara
• Format: Article
• Language: English
• Subjects: ADHD; Adolescent; Adult; Attention Deficit Disorder with Hyperactivity - diagnosis; Attention Deficit Disorder with Hyperactivity - epidemiology; Attention Deficit Disorder with Hyperactivity - ethnology; Attention-deficit hyperactivity disorder; Cross-Sectional Studies; Ethnicity - statistics & numerical data; Female; Humans; Insurance claims; Insurance, Health - statistics & numerical data; Mental health; Perinatal; Pregnancy; Pregnancy Complications - diagnosis; Pregnancy Complications - epidemiology; Pregnancy Complications - ethnology; Racial disparities; Racial Groups - statistics & numerical data; United States; Young Adult
• ISSN: 0165-0327; 1573-2517; 1573-2517
• DOI: 10.1016/j.jad.2024.08.073

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. 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. 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. 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. •Deficits in cognition and executing functioning are common complaints of pregnancy.•ADHD diagnoses among delivering women increased 290 % between 2008 and 2020.•Women of color were less likely to have a perinatal ADHD diagnosis than white women.•Increasing diagnosis may reflect improved detection but racial disparities persist.