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Tailoring screening protocols for perinatal depression: prevalence of high risk across obstetric services in Western
Janette Brooks1, Elizabeth Nathan, Craig Speelman
1Western Australian Perinatal Mental Health Unit, WA, Australia. Janette.Brooks@health.wa.gov.au
Insights
Perinatal depression screening needs adjustment. Early pregnancy screening is key, and postnatal screening should extend beyond 12 weeks to effectively manage maternal mental health.
Area of Science:
- Obstetrics and Gynecology
- Psychiatry
- Public Health
Background:
- Perinatal depression has significant negative consequences for mothers and infants.
- Longitudinal studies are crucial for understanding the timing and effectiveness of interventions.
- Existing screening protocols may not optimally capture the course of depressive symptoms.
Purpose of the Study:
- To investigate the course of depressive symptomatology during the perinatal period.
- To determine the prevalence of high-risk scores for depression across different gestational ages and postpartum periods.
- To inform the timing and efficacy of screening and intervention strategies for perinatal depression.
Main Methods:
- Utilized Western Australian data from the beyondblue National Postnatal Depression Program.
- Pregnant women completed one or two Edinburgh Postnatal Depression Scale (EPDS) assessments during pregnancy.
- Demographic and psychosocial risk factors were collected, along with one or two EPDS assessments within 12 months postpartum.
Main Results:
- Prevalence of high-risk scores ranged from 14% to 5% during pregnancy and 6% to 9% postpartum.
- For women screened twice, high-risk scores appeared earlier and decreased with advancing gestation (p = 0.026).
- Postnatal high-risk prevalence increased after 12 weeks postpartum (p = 0.029).
Conclusions:
- Screening protocols for depressive symptomatology in pregnancy may require hospital-specific fine-tuning based on gestational age.
- Postnatal screening protocols should extend beyond 12 weeks due to the persistence of depressive symptoms.
- Optimized screening timing can improve the efficacy of prevention and intervention strategies for perinatal depression.
Abstract:
Given what appears to be an ever-increasing list of concerning consequences of perinatal depression, longitudinal studies have much to offer when considering the timing and efficacy of prevention and intervention strategies. The course of depressive symptomatology across the perinatal period at four obstetric services was investigated utilising Western Australian data collected as part of the beyondblue National Postnatal Depression Program. Pregnant women completed one or two Edinburgh Postnatal Depression Scale (EPDS) assessments during pregnancy and a demographic and psychosocial risk factors questionnaire. One or two EPDS assessments were administered within 12 months postpartum. Prevalence of high risk scores across gestational ages ranged from 14% to 5% during pregnancy and 6% to 9% in the postnatal period. For women who were screened twice, the prevalence of high risk scores appeared earlier and decreased with advancing gestation (p = 0.026). The prevalence of postnatal high risk increased after 12 weeks postpartum (p = 0.029). Screening protocols for depressive symptomatology during pregnancy may need to be fine-tuned across individual hospitals, and take into account gestational ages, in order to be most effective. As depressive symptomatology persists postnatally, screening protocols may need to extend beyond 12 weeks postpartum.
