The pregnancy "super-utilizer": how does a high-risk depression screen affect medical utilization?

Area of Science:

• Perinatal mental health
• Healthcare utilization research
• Reproductive health

Background:

• The Edinburgh postnatal depression scale (EPDS) is a widely used screening tool for perinatal depression.
• High EPDS scores during pregnancy may indicate a need for increased healthcare support.
• Understanding healthcare utilization patterns is crucial for resource allocation and patient care.

Purpose of the Study:

• To investigate the association between high EPDS scores during initial prenatal visits and acute medical care utilization.
• To compare healthcare use in pregnant women with EPDS scores >11 versus ≤11.
• To identify early markers for increased healthcare needs in pregnant individuals.

Main Methods:

• Retrospective cohort study of 400 pregnant women.
• Comparison of acute medical visit frequency between women with EPDS scores >11 and ≤11.
• Definition of "super-utilization" as ≥4 acute/unscheduled visits during pregnancy and postpartum.
• Logistic regression analysis to control for confounding factors.

Main Results:

• Women with initial EPDS scores >11 were significantly more likely to "super-utilize" acute medical care.
• The adjusted odds ratio for super-utilization was 2.12 (95% CI, 1.53-3.90) for women with higher EPDS scores.
• This indicates a 2.12 times higher likelihood of frequent acute care use.

Conclusions:

• Elevated EPDS scores in early prenatal care are predictive of increased acute medical care utilization in the perinatal period.
• Identifying pregnant women with high EPDS scores allows for early intervention and support.
• Further research into interventions addressing the needs of high-risk women is recommended.