(217) Most Common Diagnoses During Pregnancy in a Commercially Insured Population of Women

Publication Number: 548

Background: As pregnant women face unique medical challenges, it is important to understand what conditions commonly impact women during pregnancy.

Objectives: To describe the most common clinical diagnoses in a cohort of commercially insured pregnant women and how they vary by trimester.

Methods: Using the Optum Dynamic Assessment of Pregnancies and Infants (DAPI) database, pregnancies were identified in medical claims data from October 2015 through October 2021. Date of last menstrual period (LMP) was estimated in two ways. For pregnancies in which at least one Z3A code was observed (83.0%), LMP was estimated by subtracting the weeks of gestation specified by the code from the service date for all Z3A codes within the pregnancy episode and taking the median date. For pregnancies without Z3A codes, we estimated the LMP by subtracting a fixed number of weeks from the pregnancy outcome date; for example, for singleton full term deliveries, 39 weeks were subtracted. We identified trimesters using the following definitions: first trimester, LMP through 13 weeks; second trimester, 14 through 27 weeks; third trimester, 28 weeks through end of pregnancy. We used 3 digit ICD-10 codes to identify the most common diagnoses among pregnancies overall and during each trimester.

Results: A total of 986,202 pregnancies were identified. 76% of pregnancies ended in livebirths, and the mean age at LMP was 31 years. Other than codes for maternal care and supervision, the most common ICD-10 diagnosis codes during pregnancy included O70 Perineal laceration during delivery (29.6% of pregnancies), R10 Abdominal and pelvic pain (18.0%), and O20 Hemorrhage in early pregnancy (15.5%). Other common diagnoses included M54 Dorsalgia (11.0%), E66 Overweight and obesity (9.9%), O24 Diabetes mellitus in pregnancy, childbirth, and the puerperium (8.3%), O13 Gestational hypertension without significant proteinuria (7.9%), and D64 Other anemias (6.8%). Nausea and vomiting (ICD-10 R11) was more commonly diagnosed in the first trimester (4.6%) than the third (2.1%). Besides diagnoses related to delivery, conditions that were more commonly diagnosed in the third trimester included F41 Other anxiety disorders (3.9% in first trimester vs 6.1% in third trimester), E03 Other hypothyroidism (3.4% vs 5.9%), and F32 Major depressive disorder, single episode (1.6% vs 3.5%).

Conclusions: The prevalence of pregnancy-related diagnoses in this cohort, such as gestational diabetes and hypertension, are in line with national estimates. These results provide insight into the prevalence and evolution of medical conditions among pregnant women.