Perinatal Depression Screening in the Pediatric Emergency Department

The optimal approach to perinatal depression (PND) screening is poorly understood. PND is associated with increased health care utilization in children. Parental PND screening during infant pediatric emergency department (PED) visits may improve detection. We aimed to identify and characterize parents in the PED with a positive PND screen and absent previous screening.

We conducted a prospective survey study on a convenience sample of parents bringing their infants (<12 mo) to our tertiary PED from September to December 2022. We included parents with English or Spanish fluency. We excluded parents of infants who required medical stabilization. Participants completed a survey that included the Edinburgh Postnatal Depression Scale, a validated PND screen. A score of 10 was considered positive. We provided resources as appropriate. We used descriptive statistics, univariate analysis, and a generalized mixed effects model to identify factors associated with a positive screen and an absent previous screening.

Of 452 enrolled parents [387 (85.6%) females, 52 (11.5%) males], 125 (27.7%) screened positive. Gender was not associated with positive screening results. While Asian/Asian American parents and those with a history of mental health conditions or symptoms were more likely to screen positive, about 1 in 4 parents had a positive screen across all parent subgroups. One in 3 subjects reported no previous PND screening.

PED visits offer a unique venue for PND screening, where high-risk parents who may otherwise go unscreened can be targeted. Our finding of a high proportion of positive screens across parent groups emphasizes the importance of universal screening in the PED setting. There is an urgent need to understand and improve the gaps in our current screening efforts.