Language-Related Differences in Prenatal Depression Screening Uptake in the USA Midwest, 2019-2024

Area of Science:

• Obstetrics and Gynecology
• Psychiatry
• Health Services Research

Background:

• Prenatal depression significantly contributes to maternal morbidity.
• Screening for prenatal depression is crucial for accessing psychiatric assessment and treatment during pregnancy.
• Updated guidelines emphasize quality metrics for prenatal depression screening.

Purpose of the Study:

• To evaluate differences in prenatal depression screening uptake based on preferred language.
• To assess screening trends over time within a large US healthcare system.
• To identify potential disparities in mental healthcare access for pregnant individuals.

Main Methods:

• Retrospective cohort study using electronic health record data from 2019-2024.
• Included deliveries at or beyond 20 weeks gestation.
• Logistic regression with language×year interaction analyzed screening probabilities by language preference.

Main Results:

• Screening uptake increased substantially from 2019 to 2024 across all language groups.
• However, the rate of increase differed significantly by language (p < 0.001).
• By 2024, screening probabilities were 0.82 for English, 0.72 for Spanish, and 0.65 for other languages, indicating divergence.

Conclusions:

• Unequal screening uptake for prenatal depression can systematically underidentify cases among non-English language preference groups.
• This disparity has significant implications for equitable access to essential psychiatric care during pregnancy.
• Healthcare systems must address language-based disparities to ensure comprehensive maternal mental health support.