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Screening for postpartum depression in a private health care network in Chile
Francisca Figueroa-Leigh1, Pamela Rojas2, Carla Castañón2
1Department of Family Medicine, Faculty of Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. ffiguerl@uc.cl.
Insights
Screening for postpartum depression (PPD) using the Edinburgh Postnatal Depression Scale (EPDS) is underutilized in Chile. Previous maternal depression history was the only factor associated with EPDS use.
Area of Science:
- Perinatal mental health
- Pediatric health services
- Public health surveillance
Background:
- Postpartum depression (PPD) significantly impacts infant development, affecting cognitive, socioemotional, and behavioral regulation.
- The Edinburgh Postnatal Depression Scale (EPDS) is recommended for PPD screening due to its higher detection rate compared to standard clinical evaluations.
Purpose of the Study:
- To assess the utilization of the EPDS for screening mothers during well-child visits for infants up to six months of age.
- To identify factors associated with EPDS use within Chile's largest private healthcare network.
Main Methods:
- A cross-sectional study analyzed 503 infant medical charts (from a universe of 5700) aged 1-6 months, attended between 2009-2011.
- Data analysis involved univariate and multivariate methods, with statistical significance set at P < 0.05 using SPSS 17.0.
Main Results:
- EPDS screening was recorded in only 1.7% (9 charts) of the 503 reviewed infant medical records.
- Maternal history of previous depression was the sole significant factor associated with EPDS recording (P < 0.001).
Conclusions:
- The documented use of the EPDS in this private healthcare network is substantially lower than recommended guidelines.
- Low screening rates highlight a gap in addressing maternal mental health within routine infant care.
Background:
It has been demonstrated that postpartum depression (PPD) has an impact on infant development with repercussions in the child's cognitive, socioemotional and conduct regulation. Screening for this disorder with the Edinburgh Postnatal Depression Scale (EPDS) has been recommended because this significantly identifies more cases of PPD than usual clinical evaluation.
Aim:
To evaluate the use of the EPDS to screen mothers attending well child care visits with their infants during the first 6 months of age and identifying the factors associated with its use in the largest private health care network in Chile.
Methods:
Cross-sectional study, conducted by random sampling of the children's medical charts from a universe of 5700 infants aged 1-6 months that attended the health care network during 2009 and 2011. Estimated sample size: 500 medical charts, assuming a recording frequency of the EPDS of 5% (confidence level of 95% and power of 80%). The descriptive data analysis of the variables was carried out using a uni and multivariate analysis. All values of P < 0.05 were considered significant (Software SPSS 17.0).
Results:
A total of 1940 visits, belonging to 503 medical charts of infants under 6 months of age were reviewed. The use of the EPDS to screen mothers was recorded in nine medical charts (1.7% of the infant population). The only variable that was significantly associated with the recording of the EPDS was the background of previous depression in the mother (P < 0.001).
Conclusion:
The record of the use of EPDS on mothers of infants seen in the private health care network is much less than what is recommended.
