Screening for postpartum depression in a pediatric emergency department
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Published on: December 6, 2024
Mary C Birmingham1, Katherine J Chou, Ellen F Crain
1Division of Emergency Medicine, Department of Pediatrics, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Insights
A 3-question Edinburgh Postpartum Depression Scale (EPDS) effectively screens for postpartum depression in pediatric emergency departments (PEDs). This brief screening tool demonstrates high sensitivity, similar to the full EPDS, for identifying mothers needing support.
Area of Science:
- Pediatric Emergency Medicine
- Mental Health Screening
- Maternal Health
Background:
- Postpartum depression (PPD) affects maternal and child well-being.
- Screening for PPD in non-traditional settings like pediatric emergency departments (PEDs) is crucial.
- The full Edinburgh Postpartum Depression Scale (EPDS) is a validated tool but can be lengthy.
Purpose of the Study:
- To evaluate the performance of a 3-question EPDS in screening for PPD within a PED.
- To compare the efficacy of the abbreviated EPDS with the full EPDS.
- To assess the feasibility of PPD screening in the PED setting.
Main Methods:
- Mothers of infants under 6 months presenting to an urban PED were enrolled.
- Demographic, social support, and food/housing security data were collected.
- Mothers completed both the 3-question EPDS and the full EPDS; agreement and test characteristics were analyzed.
Main Results:
- The 3-question EPDS showed high agreement (κ = 0.74) with the full EPDS.
- Sensitivity of the 3-question EPDS was 100% compared to the full scale.
- Factors like number of young children and food/housing insecurity were associated with positive screens.
Conclusions:
- A 3-question EPDS is a viable and effective tool for screening postpartum depressive symptoms in a PED.
- This abbreviated scale performs comparably to the full EPDS.
- Further research is warranted to confirm findings and explore impact on health outcomes.
Objective:
The objective was to determine whether a 3-question version of the Edinburgh Postpartum Depression Scale (EPDS) performs as well as the full EPDS in screening for postpartum depression in a pediatric emergency department (PED).
Methods:
Mothers of infants younger than 6 months presenting to an urban PED were enrolled. After the PED encounter, mothers were asked about demographics, health problems, insurance status, social support, food and housing security, and 3 questions from the EPDS. Mothers then completed the full EPDS. The primary outcome was the score on the full EPDS. Agreement between the 3 questions and the full EPDS for screening positive was measured. Test performance characteristics for screening positive with the 3 questions were calculated. Logistic regression determined the association between sociodemographic characteristics and screening positive. Provider impression of maternal depressive symptoms was recorded.
Results:
Of 195 mothers enrolled, 23% screened positive using the EPDS; 34% screened positive using the 3 questions (κ = 0.74). Compared with the EPDS, sensitivity of the 3 questions was 100%. Number of children younger than 5 years at home and having food and housing concerns were associated with screening positive. Of 44 mothers who screened positive on the full EPDS, providers identified 14 (32%) as having depressive symptoms or possibly being depressed.
Conclusions:
Three questions from the EPDS performed similarly to the full EPDS in screening for postpartum depressive symptoms in a PED. Future studies are needed to confirm these findings and examine whether screening improves maternal and child health outcomes and quality-of-life concerns.
