A Single Menstrual Pain Question at Routine Antenatal Visits Flags Risk of Postpartum Depressive Symptoms: A...

Area of Science:

• Obstetrics and Gynecology
• Perinatal Mental Health
• Epidemiology

Background:

• Postpartum depression (PPD) is a significant concern, necessitating early risk identification during pregnancy.
• While premenstrual disorders and dysmenorrhea are linked to PPD, their routine assessment is challenging.
• Investigating simple screening tools for PPD risk is a clinical priority.

Purpose of the Study:

• To evaluate if a single question about menstrual pain can identify pregnant women at increased risk for PPD.
• To assess the feasibility and effectiveness of a simple menstrual pain query as a PPD screening tool.

Main Methods:

• A retrospective cohort study involving 5096 women at a tertiary perinatal unit.
• Menstrual pain, documented during antenatal care, was used as a binary exposure (yes/no).
• PPD was defined as an Edinburgh Postnatal Depression Scale score ≥9 at one month postpartum; adjusted odds ratios were calculated using logistic regression.

Main Results:

• The crude risk of PPD was 7.4% for women with menstrual pain versus 5.3% for those without.
• Menstrual pain was significantly associated with PPD (aOR, 1.39; 95% CI, 1.09-1.77).
• The adjusted risk for PPD was 7.2% with menstrual pain and 5.5% without, indicating a 1.7 percentage point absolute risk difference.

Conclusions:

• A single question on menstrual pain effectively identifies pregnant women at elevated risk for postpartum depression.
• This screening method is minimally burdensome and highly feasible for integration into midwifery workflows.
• The screen can facilitate early psychosocial follow-up for women at risk of PPD.