Postpartum depression screening: are we doing a competent job?

Area of Science:

• Obstetrics and Gynecology
• Pediatrics
• Psychiatry

Background:

• Postpartum depression (PPD) affects 10-20% of mothers, impacting infant development and breastfeeding.
• Up to 50% of PPD cases remain undiagnosed, despite AAP recommendations for screening.
• Current PPD screening rates by pediatricians are low, particularly in underserved populations.

Purpose of the Study:

• To improve PPD screening rates to 75% in an inner-city primary care clinic using the Edinburgh Postpartum Depression Scale (EPDS).
• To enhance resident awareness of PPD and the importance of systematic screening protocols.

Main Methods:

• Implemented three Plan-Do-Study-Act (PDSA) cycles focusing on education, system improvements, and stakeholder engagement.
• Utilized the validated 10-item Edinburgh Postpartum Depression Scale (EPDS) for screening.
• Baseline data collected from 40 charts showed no PPD screening documentation.

Main Results:

• Screening rates increased from 0% at baseline to 33% after PDSA cycle 2, and 82% after PDSA cycle 3.
• Achieved an 82% screening rate, exceeding the 75% target goal.
• Identified eight positive PPD cases, facilitating counseling and referrals.

Conclusions:

• PDSA cycles effectively improved PPD screening rates in a primary care setting.
• The initiative successfully increased resident awareness and PPD screening implementation.
• Sustained higher screening rates post-study, though not consistently 100%.