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To describe national, state-specific, and sociodemographic trends in diagnoses of depressive disorders recorded during delivery hospitalizations.Data were analyzed from the National Inpatient Sample (2000-2015) and 31 publicly available State Inpatient Databases (2000-2015) of the Healthcare Cost and Utilization Project. Delivery hospitalizations were identified by using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) diagnostic and procedure codes for obstetric delivery. Depressive disorders were identified from ICD-9-CM diagnoses codes classified as depressive disorders in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (291.89, 292.84, 293.83, 296.2-296.26, 296.3-296.36, 300.4, and 311). Prevalence rates and average annual rate change were calculated nationally and across 28 states with at least 3 years of data and age, payer source, and race or ethnicity.The U.S. rate of depressive disorders recorded during delivery hospitalizations increased from 4.1 diagnoses per 1,000 hospitalizations in 2000 to 28.7 in 2015. Rates significantly increased in 27 of the 28 states. Recent (2014-2015) rates were lowest in Hawaii and Nevada (less than 14/1,000) and highest in Vermont, Minnesota, Oregon, and Wisconsin (greater than 49/1,000). Rates in 2015 were highest among those aged 35 years or older, public insurance recipients, and non-Hispanic white women (greater than 31/1,000). The highest annual rate increases were in Vermont and Maine (3.8/1,000 or greater). Non-Hispanic white women, those 35 years of age or older, and public insurance recipients showed the highest annual rate increases during 2000-2015 (1.7/1,000 or greater).During 2000-2015, rates of depressive disorders recorded during delivery hospitalizations increased nationally, in 27 states with available data, and across all sociodemographic categories.

OBJECTIVE: To estimate body mass index (BMI)-specific gestational weight gain recommendations and frequency of weight and gestational weight gain discussions and documentation. METHODS: Medical record review of 477 randomly selected patients who met inclusion criteria and who received care in faculty and resident clinics at a central Massachusetts tertiary care center. Patients started prenatal care at or before 14 weeks of gestation and delivered between April 2007 and March 2008. RESULTS: Our patients were mean (±standard deviation) 27.8 (±6.3) years, 69.8% multiparous, 45.3% white, 10.5% black, and 15.9% Hispanic. Mean gestational age at initial visit was 9.6 (±2.1) weeks and mean prenatal visits attended were 12.6 (±2.7). Using prenatal chart data alone, BMI was not calculable for 41.2% of patients due to missing height (27.7%), prepregnancy weight (27.9%), or both (14.5%). In the total sample, documentation was missing with regard to BMI (95.4%), gestational weight gain (85.3%), gestational weight gain goals (90.1%), and discussion of weight (88.9%). Supplemental data were obtained to calculate prepregnancy BMI for 469 patients. Per 1990 (BMI at least 26.1) and 2009 (BMI at least 25.0) guidelines, 42% and 49% of patients were overweight or obese, respectively, before pregnancy. Analysis of actual gestational weight gain by BMI revealed that 76% of overweight and 65% of obese patients gained excessively. CONCLUSION: Prenatal care providers should include recording height and weight to calculate BMI and to provide BMI-specific gestational weight gain guidelines.

INTRODUCTION:The number of reproductive-aged women undergoing bariatric surgery is increasing. Most patients have rapid weight loss in the first year or 2 after bariatric surgery, which increases their chance of pregnancy. Weight loss decreases hypertension and diabetes but increases nutritional def