Universal versus risk factor-targeted early inpatient postpartum depression screening

Area of Science:

• Perinatal mental health
• Screening efficacy
• Postpartum depression

Background:

• Early identification of postpartum depression is crucial for maternal and infant well-being.
• Current screening methods vary in efficiency and reach.

Purpose of the Study:

• To compare the effectiveness of targeted versus universal Edinburgh Postnatal Depression Scale (EPDS) screening in early inpatient settings.
• To determine the efficiency of identifying women with postpartum depression based on risk factors.

Main Methods:

• A retrospective study comparing two cohorts of women delivering between January and June 2010.
• Cohort 1 underwent universal EPDS screening; Cohort 2 received targeted screening based on identified risk factors (history of mental illness).
• Multivariable logistic regression was used to determine risk factors for a positive EPDS screen.

Main Results:

• Universal screening (Cohort 1, N=322) identified 3.4% positive screens, with a number needed to screen of 29. Targeted screening (Cohort 2, N=215) identified 15.3% positive screens, with a number needed to screen of 6.
• A history of mental illness was a strong predictor, but models without this factor had poor predictive value (number needed to screen of 80).

Conclusions:

• Targeted EPDS screening for women with a history of mental illness is an efficient method for identifying postpartum depression.
• This targeted approach may miss up to 36.4% of women who could benefit from screening and support.